Study to monitor the adverse effects by different HAART regimens in HIV patients with tuberculosis

Background: In the modern era, AIDS is not less than a disaster for the human race. More than two-third of HIV-infected individuals have an associated infectious pulmonary disease. Mycobacterium tuberculosis is more virulent than most of other opportunistic pathogen causing latent infection. HIV is characterized by a profound immunodeficiency resulting from a progressive, quantitative and qualitative deficiency of the subset of CD4 T lymphocytes referred to as helper T cells leading to the patient at high risk of developing a variety of opportunistic infections. At present AIDS is incurable but some of the drugs have shown to decrease the mortality and morbidity of the disease. These are called as Highly Active Anti-Retroviral Therapy (HAART). However, these drugs are associated with a significant number of side effects. This work has been conducted in order to study the demographic profile of HIV patients with TB and monitor the adverse effects of different HAART regimens among them.Methods: A total of 3078 patients screened for the study. Those who were diagnosed with HIV were enrolled. Pretreatment parameters like, CD4, CD8 + lymphocyte count and their ratio, haemogram etc. were recorded. Patients were divided into four groups and were started with different HAART regimens. They were monitored regularly for the appearance of any adverse effects.Results: The prevalence of HIV sero-positivity was found to be 3.60%. Out of them, 71.18% were males and 28.82% were females. The highest prevalence (43.29%) was in the age group of 21-50 years. The sero-positive rate was found more in married males as compared to married females and unmarried cases. Side effects were present in all the groups. The most common side effect was GI intolerance and was most frequent in Group I. Anemia and neutropenia occurred in the Zidovudine containing groups (group I, III and IV). Peripheral neuropathy occurred most commonly in cases of Group II. Rashes occurred in nevirapine containing groups. Liver function derangement was noticed more in group I and II. 71.4% of patients on HAART regimen showed improvement in symptoms while 28.57% did not show any improvement.Conclusions: The prevalence of HIV sero-positivity in our study was 3.60%. The rate of sero-positivity was more in males as compared to females while it was highest in the individuals of 21-50 years of age. The most common side effect was GI intolerance and was most frequent in Group I. Anemia and neutropenia occurred most frequently in Zidovudine containing groups. Peripheral neuropathy occurred most commonly in cases of Group II (Stavudine + Lamivudine + Nevirapine). Deranged lipid profile was found to occur due to indinavir in patients of Group IV. After starting on HAART regimens, 74.4% showed significant improvement in symptoms.

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Ophthalmic adverse effects of immune checkpoint inhibitors: the Mayo Clinic experience

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316970 ◽

2020 ◽

pp. bjophthalmol-2020-316970 ◽

Cited By ~ 1

Author(s):

Blake Hugo Fortes ◽

Harris Liou ◽

Lauren A Dalvin

Keyword(s):

Side Effects ◽

Adverse Effects ◽

Immune Checkpoint ◽

Ocular Surface ◽

Side Effect ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitor ◽

Checkpoint Inhibitors ◽

Common Side Effect ◽

Targeting Therapy

Background/AimsTo investigate immune-related ophthalmic side effects of systemic checkpoint inhibitors and compare side effect frequency and requirement for cessation of immunotherapy by checkpoint target.MethodsPatients taking immune checkpoint inhibitors at a single centre from January 1, 2010 to February 29, 2020 were retrospectively reviewed for clinical characteristics, treatments and concurrent systemic adverse effects.ResultsOf 996 patients, 28 (2.8%) experienced an ophthalmic side effect that came to the attention of an eye care provider. Mean age at presentation of the side effect was 63 years (median 64, range 25–88). The checkpoint inhibitor most often preceding side effects was pembrolizumab in 12 (43%). The most common side effect was dry eye in 16 (57%), followed by uveitis in 4 (14%) patients, and singular cases of ptosis and binocular diplopia, among others. Ocular surface adverse effects occurred more frequently with programmed death ligand-1 (PD-L1) targeting therapy. There were no significant differences in the frequency of orbit/ocular adnexa and uveitis or retinal side effects based on checkpoint targets. Follow-up was available in 13 (46%) patients, with mean duration of 20 months (median 16, range 2–52 months). Of these patients, the ophthalmic side effects were controlled without discontinuing therapy in 12 (92%). Checkpoint inhibitor cessation was required in one patient with panuveitis.ConclusionOphthalmic immune-related adverse events are rare but could be more common than previously estimated. PD-L1-directed checkpoint inhibitors may have a slight predilection for ocular surface adverse effects. Most ophthalmic events can be treated with targeted therapy without discontinuation of life-prolonging immunotherapy.

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Effects of the dopamine agonist cabergoline in patients with prolactinoma intolerant or resistant to bromocriptine

Acta Endocrinologica ◽

10.1530/eje.0.1340454 ◽

1996 ◽

Vol 134 (4) ◽

pp. 454-456 ◽

Cited By ~ 54

Author(s):

Etienne Delgrange ◽

Dominique Maiter ◽

Julian Donckier

Keyword(s):

Internal Medicine ◽

Side Effects ◽

Dopamine Agonist ◽

Side Effect ◽

University Hospital ◽

The Third ◽

Group I ◽

Resistant Group ◽

Group Ii ◽

Long Acting

Delgrange E, Maiter D, Donckier J. Effects of the dopamine agonist cabergoline in patients with prolactinoma intolerant or resistant to bromocriptine. Eur J Endocrinol 1996;134:454–6. ISSN 0804–4643 Cabergoline is a new long-acting ergoline derivative used to treat hyperprolactinaemia. Its effect was assessed in 10 patients (eight women and two men) with prolactinoma who were intolerant (group I; N = 7) or resistant (group II; N = 3) to bromocriptine. In group I, no side effect was observed on cabergoline therapy; two patients became pregnant and normoprolactinaemia was achieved in the five others. In group II, cabergoline was active and well-tolerated in two out of the three patients: one woman had three consecutive pregnancies; in another patient normoprolactinaemia was restored and the tumour shrank by 60%; in the third patient cabergoline was discontinued because of side effects and inefficacy. Thus, cabergoline appears to be an alternative of choice as treatment of hyper-prolactinaemic patients who are intolerant or resistant to bromocriptine. Julian Donckier, Internal Medicine and Endocrinology, University Hospital UCL of Mont-Godinne, B-5530 Yvoir, Belgium

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A cross sectional survey of side effects of antiretroviral (ARV) in outpatients HIV by Naranjo Algorithm

Jurnal Ilmiah Farmasi ◽

10.20885/jif.vol17.iss1.art4 ◽

2021 ◽

Vol 17 (1) ◽

pp. 34-45

Author(s):

Oki Nugraha Putra ◽

Keyword(s):

Antiretroviral Therapy ◽

Side Effects ◽

Side Effect ◽

Opportunistic Infections ◽

Inclusion Criteria ◽

Hiv Patients ◽

Cross Sectional ◽

Naranjo Algorithm ◽

Keywords Hiv ◽

Probable Category

Background: The main modality in HIV patients is the administration of long-treatment antiretroviral therapy (ARV). One of the problems from the use of ARV therapy is the side effects that can reduce patient compliance in taking medication, which has the potential to cause treatment failure. Objective: This study aims to examine the side effects and their causality in the use of ARVs in outpatient HIV patients at the VCT Clinic, Bhayangkara H.S. Hospital. Samsoeri Mertojoso Surabaya. Methods: This research was a prospective observational study with a cross-sectional design. Side effect data were taken from HIV patients by interview using the Naranjo algorithm. HIV patients who met the inclusion criteria were included in the study sample using consecutive sampling. This research was conducted from January to March 2020. Results: There were 72 outpatient HIV patients who met the inclusion criteria. The most opportunistic infections found in HIV patients are tuberculosis and Pneumocystis pneumonia. The results showed that the most common side effects experienced by patients were dizziness (43%), nausea and vomiting (31%), and rash (11%) with the highest Naranjo score being in the probable category of 86%. The Naranjo score in HIV patients with opportunistic infections and with comorbidities was significantly smaller than those in HIV patients without opportunistic infections or without comorbidities with independent t-test (P <0.05). Conclusion: The side effects in HIV patients while undergoing treatment with antiretroviral therapy are classified as a minor side effect and the cause of the side effects that occur is thought to be due to the probable category of ARV therapy. Keywords: HIV Patients, Antiretroviral, Side Effects, Naranjo's Algorithm.

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Ophthalmic adverse effects of taxanes: The Mayo Clinic experience

European Journal of Ophthalmology ◽

10.1177/1120672120969045 ◽

2020 ◽

pp. 112067212096904

Author(s):

Blake H Fortes ◽

Harris Liou ◽

Lauren A Dalvin

Keyword(s):

Side Effects ◽

Adverse Effects ◽

Macular Edema ◽

Side Effect ◽

Cystoid Macular Edema ◽

Meibomian Gland ◽

Nasolacrimal Duct ◽

Common Side Effect ◽

Canalicular Obstruction ◽

Clinic Experience

Purpose: To investigate ophthalmic side effects of taxanes and compare side effect frequency, requirement for cessation of taxane therapy, visual acuity outcome, and concurrent systemic effects between paclitaxel and docetaxel. Methods: Patients taking taxanes at a single center from 1/1/2010 to 2/29/2020 were retrospectively reviewed for clinical characteristics, treatments, and concurrent systemic adverse effects. Results: Of 1918 patients, 22 (1.1%) experienced an ophthalmic side effect that came to the attention of an eye care provider. Mean age at presentation of the side effect was 62 years (median 66, range 23–82). The most common side effect was meibomian gland dysfunction in 5 (23%) patients, followed by cystoid macular edema in 4 (18%) patients and canalicular obstruction in 4 (18%) patients, followed by diplopia in 2 (9%) patients, and singular cases of lash alopecia, and blepharitis, among others. Lids/lashes as well as nasolacrimal duct adverse effects occurred more frequently with docetaxel therapy than with paclitaxel therapy. Follow-up was available in 10 (45%) patients, with mean duration of 5 months (median 4, range 0–12 months). Of these patients, the ophthalmic side effects were resolved or controlled without discontinuing therapy in 8 (80%) patients. Taxane cessation was required in one patient with docetaxel-related canalicular obstruction and one patient with paclitaxel-related cystoid macular edema. Conclusion: Ophthalmic taxane-related adverse events are rare with estimated frequency of ophthalmic side effects of about 1%. Nevertheless, it is important that ophthalmologists recognize the range of side effects for optimal management. Most ophthalmic events can be treated with targeted therapy without discontinuation of life-prolonging taxane therapy.

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Chemotherapy-induced peripheral neuropathy: an update on the current understanding

F1000Research ◽

10.12688/f1000research.8053.1 ◽

2016 ◽

Vol 5 ◽

pp. 1466 ◽

Cited By ~ 40

Author(s):

James Addington ◽

Miriam Freimer

Keyword(s):

Nervous System ◽

Peripheral Neuropathy ◽

Side Effects ◽

Side Effect ◽

Chronic Phase ◽

Chemotherapeutic Agents ◽

Common Side Effect ◽

Targeted Treatments ◽

Timely Fashion

Chemotherapy-induced peripheral neuropathy is a common side effect of selected chemotherapeutic agents. Previous work has suggested that patients often under report the symptoms of chemotherapy-induced peripheral neuropathy and physicians fail to recognize the presence of such symptoms in a timely fashion. The precise pathophysiology that underlies chemotherapy-induced peripheral neuropathy, in both the acute and the chronic phase, remains complex and appears to be medication specific. Recent work has begun to demonstrate and further clarify potential pathophysiological processes that predispose and, ultimately, lead to the development of chemotherapy-induced peripheral neuropathy. There is increasing evidence that the pathway to neuropathy varies with each agent. With a clearer understanding of how these agents affect the peripheral nervous system, more targeted treatments can be developed in order to optimize treatment and prevent long-term side effects.

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Side effects of antiviral therapy in patients with chronic hepatitis C infection

Medicinski pregled ◽

10.2298/mpns1204106k ◽

2012 ◽

Vol 65 (3-4) ◽

pp. 106-110 ◽

Cited By ~ 1

Author(s):

Velimir Kostic ◽

Maja Jovanovic ◽

Jelena Radovic ◽

Stevan Vujic

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Side Effects ◽

Adverse Effects ◽

Chronic Hepatitis C ◽

Hematological Parameters ◽

Virus Genotype ◽

Group I ◽

Significant Difference ◽

Group Ii

Introduction. Chronic hepatitis C currently represents a global health problem, which is expected to be reduced by pegylated-interferon and ribavirin therapy. Material and Methods. We examined 88 patients with chronic hepatitis C, divided into three groups according to their comorbidity: the patients without comorbidity were in group I, group II included the patients on dialysis, and group III included the patients with hemophilia. Results. A significant difference was found in the percentage of achieved sustained virological response between the patients on dialysis and other patients, p<0.05. Having analyzed the therapy adverse effects, we observed a significantly higher decrease of erythrocytes count, hemoglobin and hematocrit levels in dialysis patients compared to others (p<0.01). The patients on hemodialysis predominantly had anemia and leukopenia, while thrombocytopenia was equally present in all groups. The dominant clinical side effect was flu-like syndrome, present in more than a half of patients. Discussion. The therapy positive effect is usually accompanied with adverse effects. The lowest therapeutic response was recorded in group II, due to the virus genotype 1. A significant decrease in hematological parameters was determined in all patients. The most common clinical adverse effect was flu-like syndrome, later manifestations included: weight loss, alopecia, insomnia and irritability. Side effects like psychosis, thyroid gland dysfunction or psoriasis were not recorded. Conclusion. A significant decrease in the value of all these hematological parameters was found in all groups of patients. Clinical side effects were present in 60% of patients. Side effects did not lead to discontinuation of therapy, but only to modification of drug doses.

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Short-term adverse effects of testosterone used for priming in prepubertal boys before growth hormone stimulation test

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2017-0280 ◽

2018 ◽

Vol 31 (1) ◽

pp. 21-24 ◽

Cited By ~ 8

Author(s):

Andrea Albrecht ◽

Theresa Penger ◽

Michaela Marx ◽

Karin Hirsch ◽

Helmuth G. Dörr

Keyword(s):

Growth Hormone ◽

Side Effects ◽

Adverse Effects ◽

Side Effect ◽

Serum Testosterone ◽

Low Flow ◽

Effect Rate ◽

Testosterone Levels ◽

Testicular Pain ◽

Prepubertal Boys

AbstractBackground:Despite the fact that priming with sex steroids in prepubertal children before growth hormone (GH) provocative tests is recommended, there is an ongoing controversial discussion about the appropriate age of the children, the drug used for priming, the dose and the period between priming and the GH test. Interestingly, there is no discussion on the safety of this procedure. To date, only little data have been available on the possible side effects of priming with testosterone.Methods:We analyzed the outcome in 188 short-statured prepubertal boys who had been primed with testosterone enanthate (n=136: 50 mg; n=51: 125 mg, and accidentally one boy with 250 mg) 7 days prior to the GH test. Serum testosterone levels were measured on the day of the GH test in 99 boys.Results:Overall, only five boys developed adverse side effects. Two boys (dose 125 mg) showed severe low-flow priapism and had to undergo decompression of the corpora cavernosa. One boy suffered from self-limiting priapism and testicular pain (dose 50 mg). Two patients reported testicular pain (each dose 50 mg). The single patient with 250 mg testosterone did not show any adverse effects. The total side effect rate was 2.7%. The serum testosterone levels of the boys with side effects were not different from the testosterone levels of the boys without any side effects.Conclusions:Parents and patients should be informed about the possible side effects of priming with testosterone such as priapism and testicular pain. However, the overall side effect rate is low. We found no correlation between the outcome and the testosterone dose used and/or the level of serum testosterone.

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A DOUBLE BLIND COMPARATIVE STUDY BETWEEN INTRATHECAL BUPIVACAINE AND INTRATHECAL FENTANYLAS THE INITIAL DOSE OF COMBINED SPINAL EPIDURAL TECHNIQUE FOR LABOUR ANALGESIA

10.36106/ijsr/8921758 ◽

2021 ◽

pp. 48-50

Author(s):

Niraj Kumar Mishra ◽

Sushil Kumar

Keyword(s):

Side Effects ◽

Fetal Distress ◽

Labour Pain ◽

Sampling Procedure ◽

Chi Square ◽

Double Blind ◽

Motor Weakness ◽

Group I ◽

Group Ii ◽

Fetal Oxygenation

Introduction: Labour pain is among the most severe pain a woman can experience in her lifetime. Painful labour has decrimental effects on both mother and fetus leads to severe physical and psychological stress. Maternal hyperventilation in response to pain reduces fetal oxygenation and hypoventilation between contractions combined with decreased blood ow worsens fetal hypoxemia. It has been suggested that conning women to bed during labour may cause the labour to be longer and more painful with increase in abnormal presentation, instrumental deliveries and fetal distress. Aims And Objectives:The onset, quality and duration of their analgesic action. Incidence of unwanted effects like muscle weakness, hypotension, pruritus, nausea/vomiting, fetal bradycardia by the individual drugs. Materials And Methods: The study was conducted in the department of anesthesia, Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Methods of collection of data (including sampling procedure if any) : After institutional committee approval and written informed consent from parturients and their relatives for the procedure the study was conducted and data were collected. Results: Duration of analgesia was found varying widely. It was 55±12.34 minutes in Group I whereas 75 ±14.36 minutes in Group II. The incidence of pruritus almost mild or negligible in both groups. The incidence of motor weakness in group II was 24 (80%) whereas in group I it was 10(33%). There was signicant statistics difference in motor weakness between two groups (p< 0.001) by Chi square test 9 with yate's correction. Other side effects differences between two groups were not statistically signicant. Summary And Conclusion:Both the drugs provided excellent quality of analgesia to the parturient in pain. The difference in duration of analgesia was signicant between the two groups statistically. Mean duration of analgesia lasted for 55 minutes in group I whereas in group II, it lasted for 75 minutes. Main side effects encountered in this study were motor weakness of longer duration in group II than in group I. Other side effects like nausea-vomiting were comparable to each other and were minimal in nature.

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Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

10.53350/pjmhs211592753 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2753-2756

Author(s):

Shahid Adalat Chaudhry ◽

Madiha Zafar ◽

Usman Zeeshan ◽

Mubashar Iqbal ◽

Arooj Fatima ◽

...

Keyword(s):

Side Effects ◽

Pain Score ◽

Low Dose ◽

Operative Time ◽

Oral Intake ◽

Respiratory Complications ◽

Group I ◽

Male Patients ◽

Group Ii ◽

Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

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Elucidating the Potential Side Effects of Current Anti- Seizure Drugs for Epilepsy

Current Neuropharmacology ◽

10.2174/1570159x19666210826125341 ◽

2021 ◽

Vol 19 ◽

Author(s):

Enes Akyüz ◽

Mohd. Farooq Shaikh ◽

Betül Köklü ◽

Cansu Ozenen ◽

Alina Arulsamy

Keyword(s):

Quality Of Life ◽

Side Effects ◽

Adverse Effects ◽

Side Effect ◽

First Line ◽

Epileptic Patients ◽

Life Threatening ◽

Visual Problems ◽

Gaba Transmission

: Over the decades, various interventions have been developed and utilized to treat epilepsy. However, majority of epileptic patients are often first prescribed with anti-epileptic drugs (AED), now known as anti-seizure drugs (ASD), as a first line of defense to suppress their seizures and regain their quality of life. ASDs exert their anti-convulsant effects through various mechanisms of action including regulation of ion channels, blocking of glutamate-mediated stimulating neurotransmitter interaction, and enhancing the inhibitory GABA transmission. About one third of epileptic patients are often resistant to anti-convulsant drugs, while others develop numerous side effects which may lead to treatment discontinuation and further deterioration of quality of life. Common side effects of ASDs include headache, nausea and dizziness. However, more adverse effects such as auditory and visual problems, skin problems, liver dysfunction, pancreatitis and kidney disorders may also be witnessed. Some ASDs may even result in life-threatening conditions as well as serious abnormalities, especially in patients with comorbidities and in pregnant women. Nevertheless, some clinicians had observed a reduction in the development of side effects post individualized ASD treatment. This suggest that a careful and well-informed ASD recommendation to patients may be crucial for an effective and side-effect free control of their seizures. Therefore, this review aimed to elucidate the anticonvulsant effects of ASDs as well as their side effect profile, by discussing their mechanism of action and reported adverse effects based on clinical and preclinical studies, thereby providing clinicians with a greater understanding of the safety of current ASDs.

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