Knowledge, attitude and practice of adverse drug reaction monitoring and reporting among nurses of secondary healthcare

Background: Adverse drug reactions (ADRs) are responsible for significant morbidity and mortality. Nurses will play a vital role in monitoring and reporting of ADRs. Hence this study was conducted to assess the knowledge, attitude and practice of adverse drug reaction monitoring and reporting among secondary healthcare level.Methods: In this questionnaire based study, 98 nurses working in district hospital Karwar (a secondary level healthcare facility) were grouped according to their working experience. Pre-validated questionnaire was distributed to assess the knowledge, attitude and practice of ADR monitoring and practice in their setting. Responses were converted into scores using predetermined scoring method and assessed for their level of knowledge, attitude and practice. Suitable statistical tests were applied to assess the statistical significance.Results: It has been found out that, the knowledge score ranged from 30.52±2.89 to 40.5±2.3 with no statistical significance. The attitude and practice score ranged from 43.33±2.13 to 53.85±2.67 and 23.8±4.17 to 45±7.54 respectively, with the statistical significance of 0.03 and 0.02 respectively between the groups. 72.5% participants had observed at least one ADR, while 45% of them had reported the ADR to higher authority. 82.5% of participants opined that there should be frequent awareness programs to update their knowledge on ADRs. Many factors like legal liabilities (14.5%), didn’t know where to report (24.45%), did not think reporting ADR was important (5%), non-availability of ADR reporting forms (31%) were some of discouraging factors for non -reporting of ADRs.Conclusions: We conclude from our study that even though knowledge about ADRs was relatively better despite being a resource limited setting, the attitude and practice of reporting of drug reactions needs to be improved

EVALUATION OF REVERSAL EFFECTS OF EUGENIA JAMBOLANA SEED EXTRACTS AGAINST HIGH-FRUCTOSE DIET-INDUCED INSULIN RESISTANCE IN ALBINO RATS

Objective: The objective of this study is to evaluate the reversal effects of aqueous and ethanolic extracts of jamun seeds against high-fructose (HFr) diet-induced insulin resistance (IR) in albino rats.Methods: Thirty male albino rats were divided into five groups (n=6), and all the group rats except normal control were provided with HFr (60% w/v) to their drinking water daily for 42 days. Group 1 and 2 served as a normal and fructose control. Groups 3, 4, and 5 were supplemented with metformin (MET 500mg/kg p.o) and aqueous and ethanolic extracts of jamun seeds (Jamun seed aqueous extract [JSAE] and Jamun seed ethanolic extract [JSEE] 1000 mg/kg of each p.o), from day 28 to day 42, respectively. Physical (body weights, food, and water intake) and biochemical (glucose, insulin, and lipid) parameters were estimated, and Homeostasis model assessment (HOMA)-IR values were calculated.Results: HFr diet significantly (p<0.05) increased weight gain and water intake with decreased food intake in rats. HFr-fed rats exhibited a significant (p<0.05) increase in fasting glucose, insulin, and lipid levels along with increased HOMA-IR values and confirms the development of IR. Supplementation with MET, JSAE, and JSEE significantly (p<0.05) restored the physical parameters and reversed fasting glucose and lipid levels in comparison with HFr control. Whereas, only JSAE had significantly reversed the fasting insulin levels in comparison with HFr control. HOMA-IR values were significantly (p<0.05) decreased in both the extract groups of HFr-fed rats, and the results were comparable to MET.Conclusion: Our study concludes that both aqueous and ethanolic extracts of jamun exhibit a significant reversal effect against HFr diet-induced IR, due to insulin-sensitizing actions at the target tissues

EFFECT OF ANTIRETROVIRAL TREATMENT REGIMENS ON LIVER ENZYMES IN HUMAN IMMUNODEFICIENCY VIRUS PATIENTS

Objective: Treatment of human immunodeficiency virus (HIV) with highly active antiretroviral therapy is complicated due to its effect on liver enzymes along with associated risk of opportunistic infection and its treatment. The objective of the study was to compare the effect of two zidovudine and lamivudine-based regimens on liver enzymes and to correlate them with age and CD4 count in HIV patients.Methods: In this retrospective study, patients who have received zidovudine+lamivudine+nevirapine (ZLN) or zidovudine+lamivudine+efavirenz (ZLE) at least for 1 year were included. Baseline, 6-month, and 1-year values of aspartate amino transferase (AST), alanine amino transferase (ALT), and CD4 count were collected. One-way analysis of variance and unpaired t-test were used to compare the difference in AST, ALT, and CD4 count value within basal, 6 months, and 1 year of two group and between the groups, respectively. Pearson's correlation was used for correlation study.Results: Elevation of AST levels in patients who had received ZLN regimen at different interval was significant statistically. There was a statistically significant elevation of ALT level at 6 months. There was no significant change in AST and ALT values in patients who had received ZLE regimen. Between the two regimens, there was statistically significant difference in AST and ALT values at 6 months and 1 year. There was no correlation between age and CD4 count with liver enzymes.Conclusion: We conclude from the study that nevirapine containing zidovudine regimen showed a slight elevation in AST. The efavirenz regimen did not show a change in AST and ALT