Spontaneous Adverse Drug Reaction Monitoring in a Tertiary Care Centre

2020 ◽  
Vol 15 (3) ◽  
pp. 215-221
Author(s):  
Kirandeep Kaur ◽  
Preet Kanwal ◽  
Pardeep Goyal ◽  
Paramjit Singh ◽  
Sahil Yakhmi ◽  
...  

Background and Objective: Adverse drug reactions (ADRs) are associated with increased economic burden on the society. Monitoring of ADRs can help in decreasing the incidence of preventable adverse reactions. Methods: Under Pharmacovigilance Program of India, collection and reporting of ADRs has been going on at Dayanand Medical College and Hospital since January 2011. Here, we have analyzed the individual case safety reports (ICSRs) reported and uploaded between January 2017 and June 2019 from our centre. The ADR form provided by PvPI was used for collecting information, and the causality assessment was done according to the WHO-UMC scale. Results: A total of 498 ICSRs were uploaded through Vigiflow software during this period. Highest number of ADRs were recorded in the age group of 31-45 years (29.01%) and the least number of ADRs were recorded in the children less than 15 years of age (6.76%). General Medicine ward reported the highest number of ADRs and the antibiotics were most commonly associated with ADRs (26.21%), followed by antipsychotics (13.83%) and NSAIDs (12.14%). More than 90% of ADRs were non-serious (93.17%) and most of the ADRs were skin and soft tissue related (49.20%). Conclusion: Spontaneous reporting among indoor patients shows highest number of ADRs with use of antibiotics and almost all of the ADRs were non-serious in nature. Almost half of the total ADRs were skin and subcutaneous tissue related. Continuous efforts are required for further strengthening of the pharmacovigilance program of India.


Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 



2021 ◽  
pp. 32-34
Author(s):  
Anita Sanker ◽  
G Nandakumar ◽  
Swapna Balkrishnan

There are signicant differences in the histopathology of leprosy lesions which is inuenced by the host immune response to Mycobacterium leprae. Objective - To nd the histopathological changes in newly diagnosed multibacillary leprosy(MB) cases registered in the skin department Government Medical College, Thiruvananthapuram. Method- skin biopsy performed in 40 multibacillary leprosy cases and histopathological ndings were evaluated. 70% showed epidermal atrophy. Granulomas, composed of sheets of foamy macro Results- phages, lymphocytes and epithelioid cells, were seen in 21 cases & twenty two cases were AFB positive. Eight cases each were lepromatous, borderline tuberculoid, mid boderline, borderline lepromatous types. Conclusion- Presence of 60% cases of borderline leprosy indicates the unstable immune response in leprosy patients. Majority were either borderline lepromatous or lepromatous showing the infective nature of multibacillary leprosy. Histopathological examination with Fite- Foroco staining is a crucial method and the gold standard for accurate diagnosis and typing of leprosy.



2021 ◽  
pp. 65-66
Author(s):  
R. K. Maurya ◽  
Shraddha Verma ◽  
R. K. Tripathi ◽  
Amit Yadav

Background: Hypospadias is a common congenital anomaly in which the anterior urethra is incompletely developed and does not extend to the tip of the glans penis. The present study was aimed to study the clinical prole of hypospadias. Settings and Design:This was a prospective, observational study. Methods: This prospective study was conducted at Department of General Surgery, LLR & Associated Hospitals, GSVM Medical College, Kanpur, India, from January 2019 to October 2020, on 72 patients of hypospadias, after taking clearance from the Institutional Ethical Committee, and taking proper informed consent for participation. Data collected for each patient included age, sex, demography, symptoms with duration, and relevant past and treatment history. Results: The most common age of presentation was between 1-5years of age (48.61%, n=35). Distal hypospadias (DH) was the most common site. (47.22%, n=34). 4.16% (n=3) patients presented with urethrocutaneous stula. Chordee was more commonly seen in patients with mid & proximal penile hypospadias (64.70%, n=33). In the present study, 4.1% (n=3) had associated undescended testis, 4.1% (n=3) had an associated bid scrotum and 1.3% (n=1) had an associated congenital hernia. Conclusions: Most cases of hypospadias present before 10 years of age. Distal hypospadias is the most common type. Chordee is associated most commonly with proximal penile and mid penile hypospadias. It may also be associated with other congenital anomalies like, undescended testis, bid scrotum or congenital hernias



2021 ◽  
Vol 10 (27) ◽  
pp. 2001-2006
Author(s):  
John Britto Augustin ◽  
Sureshbaboo Variamkandi

BACKGROUND Corneal ulcer is the leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of the risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcers and their prompt treatment helps to save the vision. We wanted to detect aetiological agents of corneal ulcer with special references to fungal causes and characterize the fungal aetiological agents to species level. METHODS This is a cross sectional study, conducted in Government Medical college, Kozhikode, between January 2016 and June 2017. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. A total of 120 cases were analysed. Each patient was examined with the slit lamp bio microscope after staining with fluorescein. Scrapings from cornea at the site of corneal ulcer were collected by ophthalmologist after a detailed clinical history and examination of the affected eye. The laboratory procedures used in the diagnosis of infectious keratitis were based on direct visualization of organisms by subjecting corneal scrapings to Gram stain and KOH wet mount and inoculation of material on to blood agar and Sabouraud dextrose agar. RESULTS Among the 120 cases, a total of 49 cases were culture positive. Twenty-one [17.5 %] were bacterial, twenty-two [18.34 %] were fungal and six [5.0 %] were poly microbial [bacteria and fungus]. Among the fungal aetiology, fusarium species was most common [32.14 %], followed by aspergillus species - 25.0 %. Trauma was the major risk factor. Diabetes mellitus, exposure keratitis were the other comorbidities / risk factors. CONCLUSIONS This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly fungi. Microscopy, culture, and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment. KEY WORDS Corneal ulcer, Fungal Keratitis



Author(s):  
Divya Gupta ◽  
Premlata Mital ◽  
Bhanwar Singh Meena ◽  
Devendra Benwal ◽  
. Saumya ◽  
...  

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.



Author(s):  
Toshan L. Todar ◽  
Manju Agrawal ◽  
Rajesh Hishikar ◽  
Anuja Jha ◽  
Basant Maheshwari ◽  
...  

Background: Pharmacovigilance has evolved as an important tool for dealing with Adverse Drug Reactions (ADRs) both in pre-marketing and post-marketing scenario. Underreporting of ADRs at our Adverse drug reaction Monitoring Centre (AMC) led us to conduct this study to assess Knowledge, Attitude and Practice (KAP) of the practicing clinicians at our tertiary care Pt. J.N.M. Medical College associated Dr. B.R.A.M. Hospital, Raipur, Chhattisgarh, India, towards ADRs reporting.Methods: This was a cross-sectional study using pretested questionnaires consisting of 29 questions related to KAP of the practicing clinicians at Pt. J.N.M. Medical College associated Dr. B.R.A.M.  Hospital, Raipur towards ADRs reporting. The percentage of responders for each question was calculated. All statistical analysis was performed in Microsoft Office Excel 2007.Results: Out of 135 questionnaires distributed only 100 were considered for analysis, so the overall response rate was 74.07%. We calculated the result from the 100 responders. Overall 77% responders were aware of existence of ADR monitoring system in India, while only 40% were aware of its existence at their hospital. Only 8% responders had reported ADRs to the National Pharmacovigilance Centre and 10% to the Adverse drug reaction Monitoring Centre (AMC) at their hospital. Lack of knowledge about where, how and whom to report ADRs, lack of time, inability to decide what to report (known or unknown ADRs) and unavailability of ADR reporting form were the important factors discouraging them reporting ADRs.Conclusions: Creating awareness regarding ADR reporting through CMEs among practicing clinicians and early sensitization at medical undergraduate level for medical students may improve the current ADR reporting rate.  



Author(s):  
Jayasree Hansda ◽  
Debobroto Roy ◽  
Krishnapada Das ◽  
Manojit Sarkar ◽  
Rumpa Das ◽  
...  

Background: Maternal mortality is a tragic event as family revolves around a mother. The deadly obstetrical triad of hemorrhage, preeclampsia and infection has accounted for a third of all deaths. This study was conducted to assess maternal mortality ratio, demographic profile and causes of maternal death.Methods: This retrospective longitudinal study was conducted in the department of obstetrics and gynecology for a period of three years from 1st January 2018-31st December, 2020. Total no of death during this period was 134.Records of deaths and demographic profiles were retrieved from the medical record library of aforesaid hospital.Results: There were 134 maternal deaths amongst 56815 live births with MMR 235.85. The majority of deaths were in 20-29 year of age group and most of the deaths seen in multigravida. The 91.79% death was observed within the 24 hours and after 72 hours. Eclampsia, preeclampsia and hemorrhage were leading cause of maternal death seen in the study.Conclusions: Maternal mortality is higher than national MMR. Majority of maternal death were preventable by proper antenatal care, early detection of high-risk pregnancies and their timely referral to tertiary care centre.



Author(s):  
V. Sujaritha ◽  
M. Partheeban ◽  
T. Thiviya ◽  
M. Sowmiya

Background: Stigma can prevent care and treatment of mentally ill. About 54% of diagnosable mental disorders are seen in primary care settings. There is a gross underestimation of psychiatric morbidity among patients by substantial proportion of non-psychiatric clinicians. Hence there is a need to assess the attitude towards mental illness among doctors and staff nurses. The objectives of the study were to assess the attitude towards mental illness among doctors and nurses, to compare the attitude between doctors and nurses, to find if there is any correlation between duration of training or posting and attitude, to find if educational status had any influence on attitude, to find if there is any gender influence on attitude. Methods: It is a cross sectional descriptive study conducted in a private medical college, Pondicherry among doctors and nurses who had completed their under graduation with a sample size of 221 (Doctors-120, Nurses-101). The instruments used were a semi-structured demographic profile and 34 items of OMICC (Opinion About Mental Illness in Chinese Community). The data was entered in Microsoft Excel 2013 analyzed using descriptive statistics, unpaired t-test, pearson’s correlation coefficient.Results: Only 25% of doctors and 4.9% of nurses positive attitude when overall score was considered. Doctors group had higher positive attitudes compared to nurses in domains separatism, stereotyping, benevolence and stigmatisation.Conclusions: There was no correlation between duration of psychiatry posting and attitude.



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