An observational study on dapagliflozin as an add-on therapy in type-2 diabetes mellitus patients in a tertiary care teaching hospital

Background: Diabetes mellitus is one of the prevalent morbid conditions all over the world and no exception for India. Day by day, increase in its prevalence is attributed to lifestyle derangements. To treat this condition many drugs and treatment modalities are developed. Dapagliflozin is an oral antidiabetic drug which acts by sodium-glucose cotransport-2 (SGLT-2) inhibition. Its effectiveness seen in type-2 diabetes mellitus makes it an option for Add-On therapy. Methods: This study is a retrospective observational study conducted at tertiary care hospital, GGH, Kurnool. The study proposal has been reviewed and approved by institutional ethics committee. All adult diabetic patients who were prescribed Dapagliflozin during the period of January 2021 to February 2022, total 45 were included in the study. FBG, HbA1c collected through hospital records from General Medicine and Endocrinology. Patients who stopped drug before 3 months period were excluded. Results: Administration of dapagliflozin as an add-on therapy was found 26.63% decrease in base line mean FBG 184 mg/dl to 135 mg/dl after 3mnoths which is significant (p=0.001). Mean HbA1c significantly reduced by 0.96 percentage point after 3 months (p=0.001). Dapagliflozin effectively reduced the FBG and HbA1c when used in combination with other OHAs or insulin within 3 months. Conclusions: Dapagliflozin as an add-on therapy significantly reduced the HbA1c level and fasting blood glucose of Type-2DM patients, in a 3-month treatment period. Due to the frequency of Genitourinary tract infections, caution is indicated while treating the patients

Taxanes induced hypersensitivity reactions in cancer chemotherapy patients reported at adverse drug reaction monitoring centre at a tertiary care hospital

Background: Cancer chemotherapy involves highly complex regimens using antineoplastic agents like taxanes (paclitaxel, docetaxel) etc. Taxanes cause hypersensitivity reactions (HSRs) like redness, rashes, dyspnoea, severe anaphylaxis and death. In this study, adverse drug reactions (ADRs) associated with taxanes are described & analysed on their severity and preventability. The present study aims to analyse and determine the prevalence of ADRs, especially HSRs in patients treated with taxanes.Methods: After getting IEC approval, the present study is done retrospectively by assessing the HSRs in suspected ADR reporting forms from December 2019 to February 2022 in ADR monitoring centre (AMC) in the Department of Pharmacology at Kurnool Medical College, Kurnool. Descriptive statistics used to analyse patient demography, frequency, various carcinomas under treatment & organ involved, causality assessment using WHO-UMC Scale and Naranjo's Algorithm, severity assessment using modified Hartwig & Siegel’s scale and preventability by modified Schumock & Thornton scale.Results: A total of 258 ADRs were recorded, of which 30 cases reported HSRs with taxanes-paclitaxel (22) and docetaxel (8). The most commonly occurred HSR is shortness of breath. Naranjo’s algorithm showed 52.5% possible (score 1-4) HSRs. WHO-UMC causality assessment scale showed 56.4% as probable HSRs. Modified Hartwig & Siegel severity scale showed 46.6% moderate (level 3). Modified Schumock and Thornton scale showed 76.9% as not preventable.Conclusions: Chemotherapy-related ADRs among cancer patients urges the oncologists to be actively involved in ADR reporting, in the need of the hour in order to mitigate, avoid their occurrence and reducing morbidity and mortality, when practiced with diligence

Evaluation of knowledge, attitude and practice towards drug-drug interactions among postgraduates in tertiary care hospital, Kurnool

Background: Drug-drug interactions (DDIs) are changes in a drug’s effects due to concurrent use of another drug. Clinically significant interactions lead to undesired adverse effects, therapeutic failure, toxicity or may even cause death of the patients. The Aim is to evaluate the Knowledge, Attitude and Practice of Postgraduates regarding DDIs and implementation of educational program may enhance patient’s safety.Methods: A cross-sectional study was conducted among postgraduates in all clinical departments of Government general hospital, Kurnool in the month of October 2021. Pre-validated questionnaire was used to assess the KAP. It contains demographic data, knowledge and practice questions related to DDIs and attitude towards the preferable sources of drug interaction information. Data analysis was done by using SPSS version 26.Results: Out of 220 questionnaires distributed, 126 postgraduates submitted with complete answers(n=126). Overall response rate is 57%. By using the Bloom’s cut-off points, most of the respondents (43.5%) had low level of knowledge towards DDIs. Even respondents with high knowledge level (19%) are not practicing the drug interaction screening during the admission of patients. Majority of PGs with low level knowledge agreed to ask doctors than pharmacist about DDIs and prefer to search for DDIs using reference book than online mode as the source of drug information.Conclusions: In my study, most of the respondents had insufficient knowledge to prevent life threatening DDI’s. So, there is a need to increase medical educational program regarding the importance of screening and assessing of DDI’s before prescribing medicines

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes