CR Articles

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ABOUT AUTHOR
Steffi Jerry Mammen
Inamdar Multispeciality Hospital,
Pune, Maharashtra

ABSTRACT:
Purpose: To study the adverse drug reactions (ADR’s) reported from wards and critical units in a tertiary care hospital of Pune. The adverse drug reactions were analyzed by Naranjo’s algorithm scale and Hartwig severity assessment scale and the outcomes were studied.
Methods:  This observational and cross-sectional study was conducted for 6months from November 2016-May 2017 in an inpatient setting of a tertiary care hospital of Pune. The data collection was done only in wards and critical units. Patients of all age groups and either sex were included in this study. The adverse drug reactions were assessed for their causality and severity by performing the Naranjo’s algorithm scale and Hartwig’s scale respectively. The outcomes were studied. Data analysis was done by descriptive statistics.
Result: Total 50 adverse drug reactions were reported from wards and critical units. 21-30 years age group was reported to have more adverse drug reactions. The most commonly affected organ is the Skin 32 (71.11%), followed by Respiratory system 3 (6.66%) and nervous system 3 (6.66%). Vancomycin 5 (20%) was the drug having majority of the ADR’s. The commonly reported ADR in this study was rash and itching 29 (64.44%). According to Naranjo’s algorithm scale, 23 (51.11%) suspected ADR’s were probable, 17 (37.77%) ADR’s were possible and 5(11.11%) were definite. As per Hartwig’s severity assessment scale, majority of the ADR’s were mild 21 (46.66%), followed by moderate 20 (44.44%) and severe 4 (8.88%). The outcome of the ADR’s was all recovered 38 (84.44%) during the study period.
Limitations: Study was conducted only in wards and critical units not in all departments of the hospital. Some of the ADR’s have gone un-reported by Resident Medical Officer (RMO) due to increased work pressure, lack of awareness or busy environment.

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ABOUT AUTHORS
M.S.Umashankar*¹, K.S.Lakshmi, A.Bharath Kumar, A.Porselvi
SRM College of Pharmacy,
SRM University, Kattankulathur,
Tamil Nadu, India
*abharatpharma@gmail.com

ABSTRACT : 
It is a critical clinical condition in which more abnormalities in cardiac structure and its functions may impact the ineffectiveness of the heart to supply required oxygen to meet the cellular metabolic demands of the body. Heart is covered with protective layers and express the various functions in the body. Clinically cardiac disease prevalence rises with individual age. Cardiac dysfunction happens because of changes in blood volume, and neurohumoral transmission status. These desirable mechanisms to maintain adequate cardiac output and arterial blood pressure. The neurohumoral responses act as compensatory mechanisms and provokes heart failure by increasing ventricular after load and increasing preload,which further elevates the cardiac failure. Health care system with a clinical pharmacist is well allocated to impact the disease management through identification of risk factors, stage of severity, educating the patients and health care practioners and implementing the awareness programmes, modification of life style interventions with in health care system beneficial to the community may reduce the progression of disease severity.

I reached the hospital today at 8:35 am sharp.

The reason for reaching so early, you ask? Wait, let me narrate the eventful day I had today...

Early in the morning, at 5:22 am, my phone started ringing frantically. First I thought that it was my usual morning alarm and chose to ignore it, but the phone just wouldn’t stop. I jumped out of my bed to answer the call.

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ABOUT AUTHORS:
Mazhar M¹, Ansari. A², Rajput SK^1*
1Department of Pharmacology, Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh-201313.
²Department of Social Work, University Road, University of Delhi, Delhi-110007.
*skrajput95@amity.edu

ABSTRACT
In lieu of the fact that without adequate supervision, the assurance of quality of any system is not possible; clinical pharmacy has emerged as one of the latest and unmapped discipline of pharmacy in the 21^st century. The existence of clinical pharmacists in medical rounds could support physicians in optimizing pharmacotherapy. This novel profession in India extends its diversions to good manufacturing practices, procurement/preparation/distribution of medication, reporting ADRs/ ADEs and on the whole to a very promising aspect of patient healthcare service. The state of clinical pharmacy in India is in the transformational state showing serious positive promising changes in the past couple of years. Even hospitals have started distinguishing the importance of clinical pharmacy and have taken initiatives for making it possible although at a budding stage. The clinical pharmacy branch of pharmacy is surely attaining new heights in regard to patient care services which have certainly increased the services and satisfaction to the patients.

About Authors:
Kambham Venkateswarlu
Final Year Graduate Student
Sri Lakshmi Narasimha College of Pharmacy,
Palluru, Chittoor-517132, Andhra Pradesh, India.
k.v.reddy9441701016@gmail.com

ABSTRACT:
Clinical trials are the set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for place only interventions. These trials can take place only after satisfactory information has been gathered on the quality of the country where the trial is taking place.

Depending on the type of product and the stage of its development, investigators enrol healthy volunteers and patients into small pilot studies, followed by larger scale studies in patients that often compare the new product with the currently prescribed treatment. As positive safety and efficacy data are gathered, the number of patients is typically increased. Clinical trials can vary in size from a single centre in one country to multicenter trials in multiple countries.

About Authors:
Nishant kumar singh
Research Fellow,
ICRI (Ahm) and Cranfield University
* nishantsingh.shree@gmail.com

ABSTRACT:
Over 3 decades HIV/AIDS have been a major globally accepted challenge, from endemic to a catastrophic pandemic & explodes globally. Estimates says 33.3 million HIV ^+ve and 2.6 million newly HIV infected people are in 2009. Since the beginning of epidemic, nearly 30 million people have died from AIDS related cause^[1].  From chimpanzees to human^[2] and then human to human (migration^[3], MSM, HS, IDU, MTC etc) and ultimately it transformed into pandemic. After 30 years we have advanced our treatment & Medicare knowledge of HIV and AIDS. Our scientist has developed several successful targets and drugs based on them, a highly effective therapy HAART currently in use (managing viral load & cell count for better patient survival rate) showing good results. Still HIV/AIDS is incurable, WHY? It shows the need of critical thinking from the very 1^st initial step i.e. TARGET. HIV itself is the target; biotech and Pharmaceutical Company must consider nanotechnology & homologous approach for CCR5. Though it seems that we have control over it but if this goes out same way, than one day just due to the HIV typical characteristic of mutation and recombination the worst Catastrophic sub Saharan-Africa epidemic will become Pandemic.[i]

About Authors:
Ritesh Shah*, Gaurav Chandawat, Rahul Jadav, Bhoomi Arora
Institute Of Clinical Research (India),
Ahmedabad, Gujarat-380013, India
*ritesh_shah99@yahoo.com

ABSTRACT
Venous thromboembolism (VTE) complicates approximately 1 to 2 of 1,000 pregnancies, with pulmonary embolism (PE) being a leading cause of maternal mortality and deep vein thrombosis (DVT) an important cause of maternal morbidity. The main reason for the increased risk of thromboembolism in pregnancy is hypercoagulability, which has likely evolved to protect women from the bleeding challenges of miscarriage and childbirth. Women are at a 4- to 5-fold increased risk of thromboembolism during pregnancy and the postpartum period compared with when they are not pregnant. Eighty percent of the thromboembolic events in pregnancy are venous, with an incidence of 0.61 to 1.72 per 1000 pregnancies.Includes a history of thrombosis, inherited and acquired thrombophilia, maternal age greater than 35, certain medical conditions, and various complications of pregnancy and childbirth.

Despite the increased risk of VTE during pregnancy and the postpartum period, most women do not require anticoagulation. The intensity of the anticoagulation will depend on the indication and the monitoring will depend on the intensity. At the time of delivery, anticoagulation should be manipulated to reduce the risk of bleeding complications while minimizing the risk of thrombosis. There are no large trials of anticoagulants in pregnancy, and recommendations are based on case series, extrapolations from nonpregnant patients and the opinion of experts. Nonetheless, anticoagulants are believed to improve the outcome of pregnancy for women who have, or have had, VTE.