A Descriptive Outcome Based Study for Treatment Strategies of Lower Respiratory Tract Infections using Medication Therapy Management

Lower respiratory tract infections (LRTI`s) are the fifth leading cause of death due to infections being responsible for 2.74 million deaths worldwide. Antibiotics are used primarily to treat these infections. The aim of this research is to study the medication therapy management of patients with lower respiratory tract infections admitted in ESI hospital, Bangalore, and to improve the quality of life of patients. It is a descriptive, observational, and interventional study. The data is collected through suitably designed forms and by direct interaction with the patients as well as their caretakers. The study cohort consists of 40 patients, of that males were 24 (60%) and females were 16 (40%). Most of the infected cases were in the age group of 51 to 60 years and the minimum infected were of 11 to 20 years and 81 to 90 years. The symptoms like Hyperthermia (30%), Tachycardia, and tachypnea (32.5%) were observed. A high count of RBS, PPBS, FBS were seen among 25%. Observations including leukocytopenia (7.5%), neutropenia (15%), lymphocytopenia (22.5%), leukocytosis (22.5%), neutrophilia (27.5%), lymphocytosis (35%), eosinophilia (7.5%), monocytosis (2.5%), and all cases have increased ESR (100%). LRTI was among 13 (32.5%) patients and remaining were with complications associated with LRTI. 40 (100%) patients received IV fluids along with Duolin, Budecort, Augmentin, Cough syrup, and Deriphylline. Maximum drug interactions are seen in Pantoprazole + Deriphylline combination among 14 (35%). Process measures (type and frequency of drug therapy problems detected), economic measures (number of medications dispensed), and humanistic measures, (patient satisfaction with services) were the main outcomes in this process after providing MTM services

THE DENGUE VACCINES: ASSESSMENT OF FUTURE PROSPECTS, TREATMENT, AND VACCINE CHALLENGES

Objectives: As per the national survey data, the prevalence of dengue has been still rising consistently, and the burden of the disease is predominantly affecting the adults with progression toward the DF, dengue hemorrhagic fever, and dengue shock syndrome. The higher hospitalization rate result in massive mortality. Methods: Vector control alone cannot reduce the transmission of viral infection, so effective vaccine development is made high priority. Results: Several vaccine candidates including live attenuated, live chimeric, inactivated and many other vector vaccines are key elements needed to achieve the dengue public health targets. Global strategies like diagnosis, care management, outbreak preparedness and integrated surveillance, sustainable vector control, and future vaccine implementation are needed to be addressed. Conclusion: This review mainly describes the dengue treatment challenges, in addition to a brief discussion of dengue vaccine challenges and future outlook on dengue that might help in making efficacious vaccine in near future

Determinants of Turn-Around-Time for Early Infant Diagnosis of HIV Testing: Retrospective Analysis of National Level PCR Testing Data

India has been implementing one of the biggest Early Infant Diagnosis (EID) of HIV intervention globally. The turn-around-time (TAT) for EID test is one of the major factors for success of the program. This study was to assess the turnaround time and its determinants. It is a mixed methods study with quantitative analysis of retrospective data (2013-2016) collected from all the 7 Early Infant Diagnosis testing laboratories (called as regional reference laboratories or RRLs) in India and qualitative component that can help explain the determinants of turn-around-time. The retrospective national level data available from the RRLs was analyzed to measure the turn-around-time from the receipt of samples to the dispatch of results and to understand the determinants for the same. The 3 components transport time, testing time, and dispatch time were also calculated. Transport time was analyzed state-wise and the testing time RRL wise to understand disparities, if any. Qualitative interviews with the RRL officials were conducted to understand the underlying determinants of TAT. The Median turn-around-time ranged between 29 and 53 days over the 4 years. Transport time was significantly higher for states without RRL (42 days) than those with RRL (27 days). Testing time varied from RRL to RRL and was associated with incomplete forms, inadequate samples, kits logistics, staff turnover, staff training, and instrument related issues. The TAT is high and can be potentially reduced with interventions, such as decentralization of RRLs; courier systems for sample transport; and ensuring adequate resources at the RRL level