International Journal of Basic & Clinical Pharmacology
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A prospective study on evaluation of antibiotics usage in patients with sepsis at a tertiary care hospital
Get PDFBackground: Most developing countries are adopting antibiotic usage in sepsis. This study was conducted to evaluate the antibiotic usage in patients and to study medical adherence in high-risk patients. The study in particular aims to evaluate antibiotic usage in sepsis patients along with their related ADR’s. The study also aims to optimize the usage of antibiotics in high-risk patients at a tertiary care hospital.
Methods: Study was prospective and observational review of patients record in the hospital. Clinical notes, medication chart and electronic data management system at the hospital were used to analyse usage of antibiotics. Culture and sensitivity reports were obtained from relevant departments. Observations were then compiled and documented.
Results: Out of 40 cases collected 22 (55%) patients were male and 18 (45%) were female. Majority of the study population belongs to 71 years and above with 15 (37.5%) followed by age group of 41-60 years with 14 (35%). Most frequently prescribed antibiotics were found to be meropenem 16 (21.33%) and piperacillin tazobactam 14 (18.67%). The most resistant antibiotic was found to be cotrimazole in 35 (87.5%). ADRs were found in 35% of all cases.
Conclusions: Prescribing patterns for antibiotics need to be optimized. Adherence to and update of the policy is also recommended. It was found that the adherence to hospital antibiotic policy is low
Uridine triacetate: the saviour in waiting, finally arrives
Get PDFCancer of the gastrointestinal tract is one of the very common solid cancers. Colorectal cancer is one of the types in which the anticancer drug 5-fluorouracil (5-FU) or its prodrug capecitabine is used. Toxicity to 5-FU or capecitabine is a common occurrence in patients receiving it. In such conditions, dose reduction or drug discontinuation for some time was the only way out apart from some supportive measures. An exhaustive search was always on to find a suitable antidote for the toxicity. The molecule uridine triacetate was studied for a long to be used in this condition. A systematic search of the existing literature about uridine triacetate was done with available sources like PubMed, Google Scholar, etc. Information about uridine triacetate was assembled and processed from these sources. Uridine triacetate was given orphan drug status for this indication a few years back. After a clinical trial, the drug was finally approved by the US FDA on December 11, 2015, for use in case of toxicity to 5- 5-FU or capecitabine. Well, stat Therapeutics has been marketing the drug under the trade name of Vistogard. Uridine triacetate works by preventing the toxic metabolite of 5-FU from entering and establishing itself in the RNA framework, by competing with the toxic metabolites. It is a relatively safe drug with minimal side effects. This article discusses the molecule uridine triacetate, its structure, metabolism, and kinetics in the body, the why and how of its action, and finally the results and findings of the clinical trial done with it
Role of clinical pharmacist in drug utilization evaluation, medication adherence and pharmacovigilance
Get PDFA series of systematic, criterion-based drug evaluation known as Drug utilization review are conducted on a regular basis to ensure that medication is utilized appropriately. It’s a mean of learning more about the issues brought on by drug usage, if done properly, may help to solve the issues. Medication adherence generally refers to a patient’s ability to take prescription drugs as directed and their continued use of those drugs. The increasing body of research linking medication non adherence to unfavorable outcomes and increased healthcare cost has raised concerns among clinicians, healthcare institutions, and other stakeholders. Pharmacovigilance, in which the procedures keeping an eye on the assessing adverse medication reactions, is essential to clinical practice, public health and efficient drug regulating system. Aim of the study was wo study about the role of pharmacist in drug utilization review, medication adherence and pharmacovigilance
A study assessing the knowledge, attitude, and practice of materiovigilance among medical professionals in the states of Tamil Nadu and Andhra Pradesh, India
Get PDFBackground: Medical devices are vital for healthcare diagnosis and treatment but pose inherent risks. Physicians and healthcare professionals play a crucial role in reporting adverse events associated with these devices. Despite this, there is a notable scarcity of literature addressing the knowledge, attitudes, and practices surrounding India's Materiovigilance (Mv) Program. This study aimed to evaluate the knowledge, attitudes, and practices of doctors and postgraduate residents in Andhra Pradesh and Tamil Nadu regarding the Materiovigilance program of India (MvPI).
Methods: It was conducted as an observational, cross-sectional study, a structured self-administered Google Form survey was distributed among medical professionals and citizens of Andhra Pradesh and Tamil Nadu. The survey, comprising 22 questions on knowledge, attitudes, and Mv practices, was disseminated via various social networking sites.
Results: Out of 700 doctors and postgraduate residents surveyed, 496 responded, yielding a response rate of 70.8%. The majority (96.8%) acknowledged the potential for adverse events from medical devices, with 91.1% agreeing on healthcare professionals' responsibility to report such events. Despite experiencing medical device-related adverse events in practice (63.3% of respondents), only a small fraction (12.1%) reported them, although 93.5% expressed willingness to report.
Conclusions: The study underscores a knowledge gap among physicians and residents regarding MvPI in India, highlighting the necessity for educational interventions. To address this gap, MvPI coordinators should organize conferences and seminars aimed at enhancing awareness and reporting practices among healthcare professionals
Navigating the uncommon: a case of caesarean section associated with exercise-induced anaphylaxis
Get PDFExercise-induced anaphylaxis (EIA) and food-dependent exercise-induced anaphylaxis (FDEIA) are rare but serious conditions where physical activity triggers severe allergic reactions. These are rarely reported in pregnant women undergoing caesarean section. We present the case of a 33-year-old woman with a history of EIA, scheduled for a caesarean section at 37 weeks of gestation. To manage the planned caesarean section, a multidisciplinary team strategy was devised to mitigate anaphylaxis risks. The surgery proceeded without complications under spinal anaesthesia, and the patient did not exhibit any anaphylactic reactions. The patient was monitored in the high dependency unit (HDU) and was discharged two days later. This case highlights the importance of individualized anaesthesia planning, multidisciplinary collaboration, and detailed preparation to ensure the safety of pregnant patients with EIA undergoing caesarean section.
Knowledge, attitude, and practice about antimicrobial stewardship concepts among practitioners
Get PDFBackground: Antimicrobial agents have been crucial in human medicine for over five decades. However, antimicrobial resistance (AMR) has become a significant global threat, with the world health organization (WHO) identifying it as a top ten health threat in 2019. Over 50% of antimicrobials are improperly used, leading to increased morbidity, mortality, and healthcare costs. This study assesses the knowledge, attitudes, and practices (KAP) of physicians regarding AMR to enhance antimicrobial stewardship (AMS).
Methods: A cross-sectional, descriptive study was conducted among physicians in Maharashtra, India, from December 2023 to March 2024. A self-administered survey, developed through literature review and pilot testing, was distributed electronically. The questionnaire included 27 questions across three sections: knowledge, attitude, and practice. Responses were collected anonymously.
Results: Out of 580 responses, 72% of participants were aware of AMS, with an average knowledge score of 7.3 out of 11. High awareness was noted, with 96% correctly identifying the primary goal of AMS. However, only 31.6% consistently documented the rationale for prescriptions, and 80.3% de-escalated from broad-spectrum to narrow-spectrum antimicrobials based on culture results.
Conclusions: While foundational knowledge and positive attitudes towards AMS were strong, variability in practices highlighted the need for ongoing education and system improvements. Gaps in specific knowledge areas and mixed attitudes towards newer antimicrobials and long-duration antimicrobial use indicate the need for consistent guidelines and education. Improving documentation practices, updating resistance patterns, and enhancing trust in laboratory results are crucial for optimizing AMS. Further research should address the influence of physicians' specialties, hospital types, and years of experience on prescribing behaviors
Unlocking the potential of the secretome in hair growth enhancement
Get PDFHair growth and its regulation are critical in biomedical research due to the widespread issue of hair loss. Understanding the cellular and molecular mechanisms of hair follicle development, cycling, and regeneration is essential for identifying therapeutic targets for hair growth disorders. This comprehensive literature review examined research on the biological pathways of hair follicle development, the role of the secretome in hair regeneration, and the efficacy of current hair loss treatments. Databases such as PubMed, Scopus, and Web of Science were meticulously searched for relevant studies, with a particular focus on the effects of the secretome on hair growth. The review highlights the significant role of hair follicle stem cells in wound healing through re-epithelialization and neogenesis, influenced by inflammatory cells. Exosomes from hair follicle mesenchymal stem cells containing lncRNA H19 enhanced diabetic wound healing by promoting cell proliferation and inhibiting pyroptosis. Hair follicle transplantation demonstrated the activation and differentiation of stem cells, with molecular signaling pathways between epithelial and mesenchymal cells being crucial for hair follicle regeneration. PlncRNA-1 promoted hair follicle stem cell differentiation via the EZH2/ZEB1/MAPK1 axis, enhancing wound healing. Secretome-based therapies offer a promising multifaceted approach to stimulating hair follicles and promoting hair regeneration, potentially overcoming the limitations and side effects of current treatments like minoxidil and finasteride. Understanding these mechanisms provides valuable insights for future therapeutic development in hair growth disorders
A retrospective and observational study of the adverse drug reactions reported in a tertiary care hospital
Get PDFBackground: Adverse drug reaction (ADR) is considered a common cause of prolonged hospitalization and death among patients. Pharmacovigilance is essential in the surveillance of adverse drug reactions. The responsibility of a healthcare professional is to report any adverse reaction that occurs with the use of drugs. This helps in providing a database and improving the safety of patients. The aim of the study was to determine the incidence of ADR, assess causality, severity, and preventability of the submitted adverse drug reactions, increase the awareness of preventability of adverse drug reactions in health care professionals by conducting regular workshops on ADR, and document occurrence of a rare ADR.
Methods: A retrospective observational study was conducted to assess the ADR reported to the ADR monitoring Centre, for the past 6 years included in the study. The data were entered into Microsoft excel and analyzed using descriptive statistics. Mean and standard deviation were calculated for the categorical data. Drugs were classified according to the class. Reactions were analyzed using scales and presented in descriptive statistics.
Results: A total of 95 ADR reports were received and reported. These ADRs were associated with a total of 108 drugs that were prescribed- the occurrence of ADRs dominated among females 60% (57). Antimicrobials were causing the highest number of adverse reactions 21 (19.44%) and antituberculosis drugs and radiocontrast media were associated with the following larger number of the ADRs 19 (17.59%). Intravenous at 40% was the most common route related to the development of ADR. The most common ADR caused by antimicrobials was rash (9), antitubercular therapy commonly caused hepatitis, and chills and rigors were more common with radiocontrast media. Most of the reactions observed in the patients were moderate reactions at 52.63% with 3.16% fatal ones.
Conclusions: In this study, the predominant causative drugs associated with ADR were antimicrobials, antitubercular drugs, and radiocontrast media. The number of ADRs reported though was less there was a wide range of drugs causing ADR that were reported which gave a broader spectrum for analysis. There is a requirement for active monitoring of ADRs to understand the occurrence as well as help in prevention
Supportive oncology: a blueprint for patient-centric care
Get PDFThe article emphasizes a paradigm shift toward patient-centric care while providing a thorough examination of the changing supportive oncology landscape. When a patient is diagnosed with cancer, they must not only deal with the medical effects of the illness but also manage difficult emotional, social, and practical issues. Understanding the critical role supportive care plays in improving cancer patients' overall quality of life, this book explores the essential elements of a patient-centric approach. Evidence-based procedures, recommendations, and the incorporation of patient viewpoints are all included in the suggested blueprint for patient-centric oncology care. Healthcare professionals may improve cancer patients' quality of life, foster resilience, and help create a more sympathetic and caring healthcare system by adopting an all-encompassing approach. In the end, the paper makes the case for the broad implementation of supportive oncology as a crucial part of cancer treatment, enabling patients to face their ordeal with dignity and resiliency
Eruptions in focus: cefadroxil and the uncommon realm of fixed-drug reactions: a case report
Get PDFThis case report explores a rare case of localized fixed-drug eruption (FDE) induced by cefadroxil, a first-generation cephalosporin. FDE, characterized by recurrent lichenoid lesions at specific sites upon drug exposure, is an immunological cutaneous adverse reaction. The incidence of FDE due to cephalosporins is infrequently reported, making this case noteworthy. We present a 51-year-old male who developed brownish-black patches and painful blisters on his extremities after initiating treatment with Cefadroxil for a minor toe injury. The patient's symptoms, clinical course, and subsequent recovery are detailed. Treatment involved corticosteroids, antibiotics, and topical agents. The report also provides immunological insights into FDE pathogenesis, involving CD8+ memory T cells, cytokine production, and the role of CD4+ regulatory T cells. While the exact pathogenesis of FDE remains elusive, this report sheds light on the mechanisms contributing to the self-limited nature of these eruptions. Causality assessment using the Naranjo algorithm categorized the association between cefadroxil and FDE as probable. This case report contributes to the limited literature on FDE caused by cephalosporins and underscores the importance of recognizing and managing such dermatological reactions. The broader implications of understanding FDE pathogenesis and the rarity of cephalosporin-induced cases provides valuable insights for clinicians and researchers