OBSERVATIONAL STUDY ON POISON CASES IN A TERTIARY CARE HOSPITAL

Objective: To evaluate the prevalence, pattern, and cause of poisoning. To characterize the poisoning cases admitted in a tertiary care hospital; followed by the outcome and to observe the antidote given for the poison cases. Methods: This observational study was undertaken in emergency departments (EMD) and Medical Record Department (MRD). Totally 557 poison cases was recruited in this study. Grade of poison was assessed by using poison severity score. Statistical analysis was done by using Statistical Package for Social Sciences (SPSS). Results: A total of 557 poison cases were identified in 2, 39, 828 patients out of which 360(64%) were suicidal and 189(34) cases admitted were accidental. The patients who were admitted between 2-5 h after exposed to poison were found to be more followed by 0-1 hr,>1-2 h,>6-24 h,>24 h and>5-6 h. More number of cases were seen in the others (Synthetic cow dung powder and medicine) type of poison 296(53%) followed by household poisoning 93(17%), bites 86 (15%), insecticide poisoning 64(12%) and food poisoning 16(3%). Activated charcoal was the maximum used antidote. Conclusion: Through this study, it was found that suicidal poisoning was the most common type

PHARMACIST INTERVENTION AND PREPARATION OF MANUAL IN THE ADMINISTRATION OF DRUGS THROUGH ENTERAL FEEDING TUBE

Objective: To monitor errors in current practice and prepare a manual for proper drug administration through the enteral feeding tube.Methods: It is a prospective observational study conducted for a period of 6 mo in eight departments. The current drug administrations were monitored and checked for the errors which include crushed non crushable solid dosage forms, each drug is not prepared separately, incorrect solution used for dilution, drugs mixed with feeding formula, each drug is not administered separately, not flushed before administration of each drug, not flushed after administration of each drug and others (tablets are not crushed with proper device, motors and pestles are not cleaned frequently, spillage during crushing). Using the data, a manual was prepared and submitted to the physicians of each department.Results: The most prominent error was found to be that the drugs were not prepared and administered separately, tube not flushed before drug administration. Uses of noncrushable tablets were high in neurology. Pantoprazole (enteric coated) and prazosin (modified release) tablets were the most commonly used noncrushable drugs.Conclusion: The study observed the need for developing a standard protocol for drug administration through enteral feeding tube by the pharmacist along with the physician, nursing team to improve the quality of enteral therapy

Clinical profile and triggers of migraine: an Indian perspective

Background: Primary headache disorders are among the most ubiquitous disorders affecting people worldwide. Migraine headache is one of the commonest syndromes of primary headache. There are few studies regarding clinical profile of migraine and migraine triggers in India. The objective this study was to study the gender, age distribution, frequency, severity of migraine attacks and other associated symptoms in patients presenting with migraine. To study in detail about triggers of migraine in present study population.Methods: About 222 patients who presented with history suggestive of migraine with or without aura defined according to International classification of headache disorders 2, fulfilling the study criteria were included. The study duration was fifteen months from March 2017 to May 2018. Details were collected using a proforma.Results: In this study, incidence of Migraine is higher in females (169,76%) than males (53, 24%). Majority of migraine patients were between age group of 18-29 years constituting about 77 patients (34.65%). Frequency of migraine more commonly observed was 3-4 per month was observed in 64 patients (29%) and chronic migraine was seen in 19 patients (8.4%). Migraine without aura is most common type observed in this study. Many patients had more than one trigger. More common triggers identified were sun exposure (85, 38.3%), sleep deprivation (83, 37.4%), stress (84, 37.8%) and travel (80, 36%).Conclusions: Migraine is more common in females than males with majority being in between age group of 18-29 years. Many had frequency of 3-4 episodes per month. Most had more than one trigger

KNOWLEDGE OF MODIFIABLE RISK FACTORS OF HEART DISEASE AMONG PATIENTS WITH CARDIOVASCULAR RISK

Objectives: Cardiovascular disease (CVD) is one of the leading killer diseases of people around the world. The purpose of this study was to examine the CVD risk factor and perception among individuals with high CVD risk.Methods: An observational study was conducted for 6 months in the Department of General Medicine of a Multi-Specialty Hospital. Patients who were hypertensive, diabetic, and dyslipidemia with/without comorbid disease were included. Patients who are seriously ill, mentally retarded, physical disabilities, history of CVD, etc., were excluded. CVD risk assessment was done using Framingham risk score, and knowledge assessment was done using knowledge questionnaire on CVD risk. Patient counseling was given to the patients based on their risk and knowledge level and also to improve knowledge about CVD risk and therapeutic goals for the control of blood pressure, blood glucose, lipid profile, and smoking cessation.Results: A total of 100 patients were included in this study comprising 46 males and 54 female. Male has more risk than female. The factors, viz., age, smoking habits, high cholesterol, and diabetes mellitus showed a greater risk in CVD. Knowledge levels assessed in those patients are 28% patients having poor knowledge, 30% patients having fair knowledge, and 42% patients having good knowledge.Conclusion: The study concluded that the participants showed poor knowledge in CVD, which could turn into insufficient preventative behaviors and suboptimal patient outcomes. Pharmacist implementation is needed to assess CVD risk and to improve the health-related quality of life.Keywords: Cardiovascular disease risk, Framingham risk score, Knowledge questionnaire

DEVELOPMENT AND VALIDATION OF PATIENT INFORMATION LEAFLET FOR HEART ATTACK PATIENTS

Objective: To prepare a validated heart attack patient information leaflet and to educate and promote the patient knowledge regarding the disease, lifestyle modification, and medication.Methods: The patient information leaflet was prepared by referring to the various literature. The content of the leaflet was validated by ensuring the quality information for patient's method. Baker able leaflet design has been applied to develop the layout and design of the PILS and readability by Flesch readability score.Results: The mean validity score by EQIP method achieved for the leaflet was 84.9%. Flesch readability score is 72.4. Scoring for the leaflet's layout and design criteria based on baker able leaflet design method was 24. The overall knowledge assessment means score was statistically significant with *P value 0.000.Conclusion: The validated heart attack PILs found to be effective in patients self management

ASSESSMENT OF DRUG RELATED PROBLEMS IN PATIENTS WITH CHRONIC DISEASES IN THE GENERAL MEDICINE UNITS OF A TERTIARY CARE HOSPITAL

Objective: Patients with chronic diseases are more prone to develop drug-related problems (DRPs), which can further worsen their quality of life. The aim of this study was to determine factors and medications associated with DRPs in patients with chronic disease.Methods: This prospective interventional study was conducted for a duration of 6 mo in the in-patients of general medicine department of PSG Hospital, Coimbatore. DRPs were identified, assessed and recorded as per pharmaceutical care network Europe (PCNE) V5.01 criteria. Chi-square and correlation test were used to analyze the data for identifying factors associated with DRPs.Results: A total of 137 patients were enrolled for the study, of which 66 patients developed DRPs. The most prevalent DRP was found to be drug choice problem. The major causes of DRPs were found to be drug and dose selection. Antidiabetic drugs were found to be more associated with drug-related problems. The incidence of drug-related problems was high in patients aged between 50 to 59 y. Association between gender, length of hospital stays and polypharmacy with DRPs was found to be statistically significant. 58.33% of the total drug-related problems were completely solved and 19.05% were partially solved.Conclusion: The incidence of DRPs in the General Medicine department of the hospital was high. The use of an appropriate tool such as PCNE may assist pharmacists and other healthcare professionals to systematically identify, categorize and report drug-related problems

IMPACT OF PHARMACIST EDUCATION ON MEDICATION ADHERANCE IN HEART FAILURE PATIENTS

Objective: To determine whether pharmacist intervention improves the medication adherence in the heart failure population and to identify the barriers affecting adherence. Methods: A prospective interventional study was conducted in 1000 bedded multi specialty private hospital to assess the medication adherence through pharmacist counseling and barriers involved in adherence by using Morisky medication adherence. Results: The male heart failure population (88%) was predominant compared to females (12%). The 51-70 year age group patients were identified to have lower adherence rate (37.3%) followed by 71-90 year population with 25.3% adherence rate. The adherence score was obtained at baseline and after 6 months which showed statistically significant improvement*P<0.0001. The major adherence barrier was forgetfulness (63%) under patient related problem and polypharmacy was the major factor under medical related barrier (27.7%). Conclusion: The pharmacist based intervention and counseling improved medication adherence in heart failure patients. The major barriers identified can be overcome by continuous intervention by the pharmacist especially in a chronic disease like heart failure