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: Sickle cell syndromes are commonly encountered inherited haematological disorders regarding which sparse published data are available from Telangana State. Methods: Prospective study of 55 patients diagnosed to have sickle cell syndromes at our tertiary care teaching hospital in Hyderbad, Telangana State, South India. Results: Their mean age was 19.9 (range 3-48) years; there were 35 males. Consanguinity was noted in 31%. History of cholecystectomy was evident in 5 cases. Blood transfusions were received in the past in 52% of cases. Symptoms at presentation were jaundice (85%), pain (80%), fatiguability (60%), pallor (30%), dyspnoea (29%), lump abdomen (7%) and leg ulcer (3%). Acute chest syndrome was seen in 10.9% cases. Physical examination revealed pallor (90%), icterus (80%) hepatomegaly (49%) and splenomegaly (41%). Mean haemoglobin at presentation was 8.3 g/dL. Sickle cells were seen in peripheral smear in 51%. Sickling test was positive in all after induction. Characterization of haemoglobin by high performance liquid chromatography revealed homozygous sicke cell anaemia was evident in 22/ 43 (51.2%), sickle thalassemia in 16/43 (37.2 %) and sickle cell trait in 5/43 (11.6 %). Conclusions: Sickle cell disease should be considered in the differential diagnosis while evaluating patients presenting with anaemia and skeletal pains. Prompt recognition and management improves survival and eventual prognosis in these patients.
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