Australasian Medical Journal
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Reporting Adverse Drug Reactions in Nepal
No full textBackground Pharmacovigilance is the “science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problems”. Nepal joined the international pharmacovigilance programme as a full member in 2007. KIST Medical College, Lalitpur, Nepal joined the national programme as a regional centre from mid-July 2008. Currently, the pattern and scope of adverse drug reactions (ADRs) in Nepal remains unexplored. Aims To observe and analyse the pattern of ADRs at KIST Medical College, Lalitpur, Nepal. Method A retrospective analysis of all ADRs reported to the centre from mid July 2008 to July 2011 was performed. Data was analysed for ADR severity, causality, and preventability. Results A total of 113 ADR reports were obtained from various clinical departments. The maximum number of reactions was due to antimicrobials, followed by anti-hypertensives and NSAIDs. ConclusionAntimicrobials were the commonest group of drugs causing ADRs and the most commonly seen ADR was maculopapular rash followed by diarrhea and vomiting
Infant Feeding: Milk sharing
No full textThe advent of Internet forums that facilitate peer-to-peer human milk sharing has resulted in health authorities stating that sharing human milk is dangerous. There are risks associated with all forms of infant feeding, including breastfeeding and the use of manufactured infant formulas. However, health authorities do not warn against using formula or breastfeeding; they provide guidance on how to manage risk. Cultural distaste for sharing human milk, not evidenced-based research, supports these official warnings. Regulating bodies should conduct research and disseminate information about how to mitigate possible risks of sharing human milk, rather than proscribe the practice outright.
Sub Acute Sclerosing Pan Encephalitis
Get PDFSubacute sclerosing pan encephalitis (SSPE) is a rare neurodegenerative disorder related to a persistent and aberrant measles virus infection. It is associated with poor prognosis and high mortality. We report a case of a seven-year-old boy who manifested the disease despite proper vaccination and with no documented past history of measles. The case is being reported for its atypical presentation, rarity and its possibility of occurrence in young vaccinated subjects, possibly due to undocumented pre-vaccination measles infection
Visceral Leishmaniasis
Get PDFAlthough leishmaniasis is widely prevalent in the eastern states of India namely Bihar, Jharkhand, Uttar Pradesh and West Bengal, diagnosing the illness is still difficult. We present a case of a 20-year-old agricultural labourer with a history of recurrent fever, progressive weakness and abdominal discomfort associated with loss of appetite for six months followed by petechial hemorrhages over body. On examination there was hepato-splenomegaly. A diagnosis of visceral leishmaniasis (kala-azar) was made based on the bone marrow aspiration cytology and epidemiological history of the illness. Routine blood investigations showed pancytopenia and a chest X-ray was normal. The patient was treated by intravenous administration of amphotericine B, the patient responded favourably to treatment
A Rare Case of Infection with Brucella Suis
No full textBrucellosis is a chronic infection produced by members of the Brucella family. Diagnosis of this condition requires either isolation of the organism in culture or positive serological tests. We describe a 27-year-old male admitted as a case of pyrexia of unknown origin (PUO), who tested negative for Brucella IgM ELISA test on preliminary evaluation but was subsequently diagnosed on the strength of positive blood and bone marrow cultures to be a case of brucellosis secondary to Brucella suis infection. In addition to highlighting the pathogenic potential of an unusual organism, this case demonstrates the unreliability of standard serological tests based on the Brucella melitensis antigen for infection with other species of Brucell
HIV Infection and CD4 Cell Count
No full textBackground HIV infection is associated with a wide range of haematological abnormalities. Methods and Objectives The objectives in this study were to study haematological changes in HIV patients and to correlate them with CD4 cell counts. Two hundred and fifty HIV positive patients referred to the haematology laboratory section for complete haemogram in whom CD4 count was done were included in the study. Haematologic parameters and CD4 counts were studied in each of these patients. Descriptive statistics were applied. Association between two attributes was calculated by chi-square test and p value less than 0.05 was considered statistically significant. Results Among 250 patients, anaemia was seen in 210 (84%) cases. The most common type was normocytic normochromic (40.4%). Lymphopenia was seen in 163 (65.2%) cases and thrombocytopenia in 45 (18%) cases. The majority of cases (70%) had CD4 cell counts below 200 cells/mm3. Fifty-four cases (21.6%) had CD4 counts between 200 to 499 cells/mm3 and 21 (8.4%) cases had CD4 counts more than 500 cells/ mm3. In patients with CD4 counts less than 200 cells/mm3, anaemia was seen in 91.4% cases, leucopenia in 26.8% cases, lymphopenia in 80% cases and thrombocytopenia in 21.7% cases. Conclusion Haematologic manifestations of HIV infection are common and more frequent with progression of disease. The present study revealed a significant increase in the number of cases of anaemia, and lymphopenia, with decreasing CD4 cell counts. Thrombocytopenia is also seen but does not show significant increase with disease progression. The study also highlights the importance of simultaneously treating HIV patients for haematologic manifestations to reduce morbidity