ADVERSE DRUG REACTIONS AMONG DRUG-RESISTANT TUBERCULOSIS TREATMENT: AN OBSERVATIONAL COHORT STUDY

Objective: Adverse drug reaction (ADR) is regarded as one of the major challenges in the treatment of drug-resistant tuberculosis (DR-TB). It can lead to non-compliance or interrupting treatment completion, which can contribute to avoidable morbidity, drug resistance, treatment failure, reduced quality of life, or mortality. Methods: A retrospective cohort study was conducted in the Ernakulam district of Kerala from 2016 to 2019. All DR-TB patients registered under the DR-TB center were enrolled in the study. Due to privacy and confidentiality HIV infected patients and patients below 12 y of age were excluded in this study and only the data with ADR reported by patients is collected from medical records. Results: Out of the total 146 patients, about 75 % of patients experienced at least one ADR during treatment, and a total of 208 ADRs were reported. Among all the ADRs, the most common ADR was gastritis (12.98%) followed by ototoxicity (10%) and vomiting (5.76%), etc. It was found that males (78.76%) within the age group 46-65 y exhibited more ADR than females. Some of the ADR requires drug withdrawal and replacement with other drugs and most of the patients also needed symptomatic treatment without modifying the treatment regimen. All ADR reported were collected and causality assessment was done via WHO and Naranjo scale. The majority of ADR belongs to the “probable” category in the WHO scale and Naranjo scale. The evaluation of the severity of ADR by using the Modified Hartwig and Siegel scale indicated that most of the ADR was of moderate level showing a 4b reaction. The study also assessed the preventability of ADR using the Schumock and Thornton preventability scale. Conclusion: Many of the ADRs were unidentified or not reported due to several reasons like milder ADR, patient lack of knowledge, Negligence of symptoms, unawareness of health providers, etc. Whereas the long-term treatment and diversities in age, gender, etc. were found as major contributors to ADR along with comorbidities. New drugs in combination with existing drugs created the potential for previously unnotified reactions. Pharmacovigilance should address the safety of therapy and identify ADRs, especially the serious ones with routine monitoring to prevent mortality, morbidity, and other negative outcomes

CONVALESCENT PLASMA THERAPY: A NOVEL APPROACH TO A NOVEL CORONAVIRUS

Objective: The Corona virus-induced disease-19 (COVID-19) turning to its aggressive phase of spreading, the treatment options where less and several options are trialing and seeking. Convalescent plasma therapy is one of the newest trailing therapy for COVID patients today without other definite treatment. The convalescent plasma (CP) therapy is used previously and identified its benefits in other conditions. But in the case of COVID 19 the effects and safety should be ensured for its implementation. Methods: Systematically searched in Pub Med and other authentic sources for articles of interest. Results: This review includes 5 studies, over all 26 patients who treated CP and following progressions and events. All became clinically better and the antibody titer increased in the patients. Not only that the viral load decreased with a reduction in inflammatory markers Conclusion: These small studies and case series suggest that CP is effective and safety is high for clinical recover and reduction in viral load

Impact of Digitalization in the Eye Strain during Covid-19 Lockdown Period: An Epidemiological Study

Background: Over past few months due to COVID-19 lockdown, our society has been in indoor settings where the education, work and entertainment are through digital platform. This created an increase in rate of digital eye strain. Method & materials: An epidemiological observational study conducted during lockdown period among people of Kerala with a structured and validated questionnaire using Google form. People with age ≥ 18 years, using digital screen on continuous basis were included in the study.Inform consent were collected from the participants before the survey.The statistical analysis were done using SPSS software. Results and Discussions: A total of 584 were participated in the study where more than 86% reported at least one symptom. Smart phone and computer were the major platform used by participants mainly for learning and entertainment.31% of participants were continuously using digital screen for >2hours.One fourth of participants were using the screen for >9 hours and a 20% uses the screen in dark room or dim light for >5 hours. 66% had mild and 2.2% had severe symptoms.Headache was the common symptom found followed by eye pain and neck/shoulder/joint pain. Females were found to be more prone to develop CVS. Headache, eye redness, burning, etc. were correlated with duration of use. Conclusion: The digital screens demands high visual strain, much attention and care should be taken for vision problems and related issues.Since we are depending on digital screens for many of the daily activities, the information related to CVS and associated discomfort along with the prevention strategies should be explained by health professionals. Keywords: Digital Eye Strain, Computer vision syndrome, Lockdown, COVID-1