Clinicaltrials.gov: NCT01340768.

Context: Adverse drug reactions (ADRs) can result in a number of consequences, ranging from allergic reactions to permanent harm thereby causing morbidity and mortality leading to an increase in the health care costs. Aims: The main objective of the present study was to assess the prevalence of adverse drug reactions due to cardiovascular drugs in patients admitted to a secondary care hospital. Material and Methods: This was a prospective surveillance study which included adult patients of either gender who were hospitalized and prescribed with at least one cardiovascular drug. Patients were monitored from the day of admission till the day of discharge for the occurrence of ADRs due to cardiovascular drugs by attending clinical meetings, ward rounds, reviewing patients' medical records and electronic medical records. Results: A total of 309 patients were enrolled in the present study. Among them, 72 patients experienced 109 ADRs accounting for an incidence of 23.3%. Twelve (3.88%) patients were hospitalized due to ADRs (n=16) whereas 60 (19.41%) patients developed ADRs (n=93) during their hospital stay. Male preponderance was observed over female. Patients with age ≥ 60 years experienced 73 ADRs. The most common drug class implicated in ADRs was observed to be beta blockers (18; 16.5%) especially bisoprolol (16; 14.68%). Majority of patients experienced bradycardia (11; 10.09%) followed by hypotension (9; 8.26%). Cardiovascular system (30; 27.53%) was observed to be the most common system. Majority of ADRs were possible (80; 73.39%) in nature, mild (53%) in severity and not preventable (84.5%). Conclusion: Intensive approach towards monitoring and reporting of ADRs could help healthcare professionals in minimizing preventable ADRs.

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Osteoarthritis (OA) is a degenerative joint disease that causes persistent joint pain and stiffness of mainly the large peripheral weight-bearing joints. It is a leading cause of functional disability and poor quality of life. Various modalities of therapy are recommended by different research organizations at different stages of OA including non-pharmacological, pharmacological, and surgical interventions. Intra-articular injections of hyaluronic acid (HA) is widely used for over three decades in the treatment of OA. However controversies exist regarding its safety and efficacy, the number of injections and courses, type of preparation, duration of its effects, and combining it with other drugs or molecules. This study aimed to review the most recent data available in the published literature to address these. Electronic databases like Medline, Embase, ProQuest, and Google Scholar were searched for articles using keywords, intraarticular injections, hyaluronic acid, and osteoarthritis knee. The review was carried out as per PRISMA guidelines. Thirty-eight randomized control trials (RCTs) investigating the efficacy and safety of intra-articular injection of HA were included in the systematic review. Out of the 38 studies, 22 (57.9%) were double-blind, eight (21%) single-blind, three (7.9%) non-blind, four (10%) with simple randomization, and one (2.7%) was open-labeled. Total 5,025 patients were included in these studies. The mean age of the patients was 60.28 years and the osteoarthritis grade of the knee joint was 1 to 3. HA was studied as a test preparation in 19 (50%) while in another 19 (50%) it was studied as a control. In 24 (63.2%) studies, HA was used as high molecular weight preparation in eight (21%) as low molecular weight preparation while in six studies the information was not available. HA was used as a standalone preparation in 31 studies, in two studies it was injected with platelet-rich plasma (PRP) and with either low-level laser therapy (LLLT), triamcinolone (TA), betamethasone (CS), poly deoxyribonucleotide (PDRN) or dexamethasone (DX) in one study each. In the majority of the studies, HA was given as a single injection (52.6% studies) or weekly three injections (28.9% studies). In 13.2 %, it was given as weekly 5 injections and in 5.3% as weekly two injections. IA-HA injections have a limited role in the treatment of knee osteoarthritis in those patients who do not have sufficient pain relief with topical or oral medication and physical therapy. It is safe and effective except for minor side effects such as local pain and swelling lasting for a few days. Severe allergic reactions are extremely rare. They provide adequate pain relief and functional improvement for up to six months irrespective of a number of injections and type of preparations used. The combination formulations with corticosteroids or PRP or MSCs show better results than HA alone. Combining HA with newer molecules such as peptides or diclofenac for sustained and disease-modifying effects...

Description: The COVID-19 pandemic compelled the traditional higher educational institutions to make a quick transition to the virtual instruction model. Considering the COVID-19 restrictions, the Department of Clinical Pharmacy and Pharmacology at Ras Al Khaimah College of Pharmaceutical Sciences, United Arab Emirates restructured their original onsite experiential training for final year Bachelor of Pharmacy students as a virtual online experience to ensure educational continuity. Evaluation: The virtual experiential training was conducted over two weeks and was imparted employing different virtual platforms like Google Classroom, Google Meet, Google Forms, Google Docs, etc. As a part of the community pharmacy training, the students were given different e-activities and tasks like e-case scenario analysis and interpretation, e-prescription screening, virtual patient education and were shown various 3-D animated videos related to community pharmacy. For the hospital training, the students were given different e-cases for developing pharmaceutical care plans, e-case scenario analysis, e-drug information query and were shown different animated videos related to rounds of different hospital departments. Conclusion: The virtual experiential training was successfully conducted achieving the desired learning outcomes and was well received by the students. Based on this experience, it is recommended that efforts should be made to develop an integrated model for experiential training in the future, which can be an amalgamation of online tools and traditional experiential methods.

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Background: Drugs are used for the well-being of an individual but apart from its effectiveness many adverse effects are observed. Antipsychotics are the mainstay of treatment for psychotic disorders. Most of the first generation and to a lesser degree second generation antipsychotic agents are associated with ADEs like extra pyramidal symptoms (EPS), sedation and anti-cholinergic side effects. Method: This study was conducted at a tertiary care hospital. Informed consent was obtained from patients care takers. Patients aged ≥18 years of either gender admitted to psychiatry department were included in the study. Patients on OPD basis, emergency, ICUs and special population were excluded. The main objective of the study was to estimate the incidence of ADEs and evaluate ADEs based on various parameters like demographics, drug class implicated, individual drug implicated, organ system affected, and analysis of ADEs (causality, severity and preventability). Result: A total of 58 patients were enrolled into the study. Out of them, 32 patients experienced 90 ADEs. The incidence rate was found to be 55.17%. Male (65.51%) preponderance was observed over females (34.48%). Benzodiazepine was reported to be one of the major drug class implicated in which Lorazepam accounted for 36.51% ADEs. CNS was one of the most prominent systems affected due to ADEs. Conclusion: The fact goes undenied, psychiatric patients are prone towards adverse events, the only good that could be done to these subjects is try avoiding and minimizing the events. This could be possible only by thorough monitoring of such cases. Our results showed incidence rate of 79.31%. This incidence rate could be minimized by the presence of a clinical Pharmacist for better treatment and creating awareness of the medicines to the patients.