Perception of doctors towards Adverse Drug Reaction (ADR) reporting: a cross sectional survey using a validated questionnaire

Background: Several studies have shown lack of sufficient knowledge and awareness among doctors on ADR reporting. Knowledge and attitude of doctors about ADR greatly influences extent of reporting. Identifying factors affecting ADR-reporting is vital to enable Pharmacovigilance teams to implement interventions to enhance rate and quality of reporting of ADRs. Hence, this study is done to evaluate perceptions of doctors towards ADR-reporting and to determine barriers for reporting ADR.Methods: Cross sectional study conducted among doctors using a validated questionnaire to assess knowledge, attitude, practice and barriers for reporting ADRs. The questionnaire captured the demographic details, knowledge (14), attitudes (7) and practice pattern (4) towards pharmacovigilance. Descriptive statistics was used to assess the response among doctors.Results: Of 157 doctors who responded to questionnaire, 90% of doctors were aware of pharmacovigilance program mainly through PVG activities by AMC and pharmacology classes. Only 47% doctors reported ADRs. The composite score on knowledge of ADR reporting and on knowledge of ADR burden was found to be moderate. 90% doctors opined ADR monitoring in hospital should be mandatory. 83% doctors opined ADR reporting by one person can make significant difference to community. One-third doctors felt there should be financial reward for ADR-reporting. In suspected cases, 57% doctors include ADR as differential diagnosis. 61% doctors said they will document ADR in patient file and 78% reports to AMC. More than one-third doctors don’t know where and how to report ADR. One-third doctors felt management of patients was more important than reporting ADR. Nearly one-fourth didn’t report fearing legal liabilities, difficulty diagnosing ADR and negative impact on doctors.Conclusions: Knowledge about ADR-reporting and attitude towards it is adequate. But, because of many barriers, actual practice of ADR-reporting is unsatisfactory. Hence, Pharmacovigilance training is essential for doctors to promote and improve ADR-reporting

Adverse drug reactions reporting among nursing staff and students: a validated questionnaire based knowledge, attitude and practice study

Background: Lack of knowledge regarding pharmacovigilance and adverse drug reaction (ADR) reporting among healthcare providers have been identified as major factors for under reporting of ADR in developing countries. Hence this study was planned to assess the knowledge and attitude of nursing faculty and students towards ADR reporting and also to determine the barriers to reporting ADR.Methods: A validated questionnaire based cross sectional study conducted among the nursing faculty and students in a tertiary health care center. Data was assessed by frequency, percentage, mean and standard deviation. Statistical analysis was performed by using SPSS version 22.Results: The composite score on knowledge on ADR reporting was found to be moderate among nursing staff, GNM and BSc nursing students. The knowledge on burden due to ADR was found to be poor among all the three categories. Around 70% of all the respondents were of the opinion that ADR reporting by one person can make a significant difference to the community. More than 80% of nursing staff and GNM students opined one should have a suspicion of possible ADR during treatment. Majority of the nursing staff were in favour of mandatory and voluntary ADR reporting in the hospital.Conclusions: The nurses were only moderately aware of pharmacovigilance and adverse drug reaction reporting. Though the attitude towards ADR reporting was adequate, our study has shown that the actual practice of ADR reporting is unsatisfactory. Hence, it is essential to include pharmacovigilance training in the undergraduate teaching programs of nurses to promote reporting of adverse reactions

Anti-diabetic drugs prescription pattern by postgraduate students among type 2 diabetes patients attending a tertiary care hospital

Background: The pattern of prescribing anti-diabetic drugs varies among different medical professionals due to the availability of numerous anti-diabetic drugs and demographic and have increasingly favoured for tighter control of glycemic index. Even with the available multiple therapies many patients are not in control. The reasons may be multi factorial and the one important factor is the drugs prescribed.Methods: This cross-sectional study involving 140 type 2 adult diabetes patients was done to assess the pattern of anti-diabetic drugs prescribed by the postgraduate students in a tertiary health care center using a specially designed questionnaire.Results: Oral medications were predominantly prescribed. Metformin and Glimepiride combination was prescribed in majority. Among insulin, combination of short and intermediate acting insulin was prescribed more and the number of insulin prescription increased with the duration of diabetes. Interestingly no newer classes of drugs are prescribed.Conclusions: There is a rational prescription pattern of antidiabetic drugs but newer antidiabetic drugs are not prescribed and life style changes are not discussed with the patients. There is a need to include life style changes as a part of prescription to all the patients.

A prospective, randomized, double blind, comparative study of intramuscular nalbuphine hydrochloride, butorphanol tartrate and pentazocine lactate for post-operative pain relief following abdominal hysterectomy

Background: This study aimed to compare the efficacy and safety of intramuscularly administered nalbuphine, butorphanol and pentazocine for post-operative pain relief after abdominal hysterectomy.Methods: Seventy-five adult female patients, aged between 20-50 years, belonging to American Society of Anaesthesiologists (ASA) class 1 and 2, posted for abdominal hysterectomy under spinal anesthesia were included in the study. The subjects were randomly divided into 3 groups (n=25 each) and given – Group A: pentazocine lactate (30 mg, 1mL), Group B: butorphanol tartarate (2 mg, 1 ml) and Group C: nalbuphine hydrochloride (10 mg, 1 mL) when post-operative pain intensity reached ≥4 mm on the Visual analogue scale (VAS). The onset, duration, time to peak effect and adverse events were recorded at regular intervals for 24 hours, postoperatively.Results: The mean time to onset of anesthesia was significantly faster (P<0.05 each) in the nalbuphine (10.2±2.2 minutes) and butorphanol (11.3±2 minutes) groups when compared to the pentazocine group (14±2.7 minutes). Duration of analgesic action was significantly longer (P<0.05 each) in the nalbuphine (236.4±75.1 minutes) and butorphanol (202±59.2 minutes) groups when compared to the pentazocine group (177.4±55.3 minutes). No significant differences in respiratory and cardiovascular parameters were noted between the groups. Nausea and vomiting was seen significantly higher in the pentazocine group (36%) when compared to butorphanol (20%) and nalbuphine (8%) groups (p<0.05 each).Conclusions: Intramuscular nalbuphine and butorphanol provided effective analgesia with rapid onset and longer duration of action, with lower incidence of nausea and vomiting when compared to pentazocine. In particular, nalbuphine can be a suitable agent to provide post-operative pain relief in gynecologic lower abdominal surgery

Assessment of Curcuma longa linn. on learning and memory in rats

Background: There is an increase in elderly population and memory-related disorders. Curcuma longa linn. can induce cognitive improvement due to its antioxidant effects. This study evaluated the effect of chronic administration of C. longa linn. on learning and memory in rats.Methods: Twenty four female Albino Wistar rats were randomized into control, standard, and test groups. The control group received 0.5% methyl cellulose; the standard group received piracetam and test group received C. longa orally for 24 days. Water maze and step-through passive avoidance test were used to evaluate the effect of C. longa linn. on learning and memory. Water maze training was done from day 23 to day 26. Assessment of spatial memory was done on day 27 and retention memory on day 29.Results: The mean escape latency (EL) in control, standard, and test group was 42.48, 30.45, and 30.88 sec on day 23 which decreased to 11.08, 11.36, and 9.66 sec on day 26, respectively. The EL in all the three groups decreased from day 23 to day 26 (p<0.01). The time spent in the target quadrant was more in the test group (21.25 sec) compared to control (19.73 sec) and standard group (19.79 sec) (p=0.768). In passive avoidance test, test group showed a trend toward improvement in retention memory (p=0.293).Conclusion: C. longa linn. may be useful in enhancing learning. Further dose ranging preclinical studies are required to evaluate the efficacy of curcumin on memory

High altitude Records of the House Crow Corvus Splendens in Western Arunachal Pradesh, India

Volume: 105Start Page: 339End Page: 33

Optimization of screening and emitter density for an array of carbon nanotube field emitters

583-586In order to exploit the high current carrying capacity of Carbon Nanotubes (CNTs), it is important to maximize current density J by controlling screening as well as the emitter density. A model is developed in MATLAB to calculate the current density from an array of nanotube bundlestaking into account both the effect of screening and the emitter density in the framework of standard Fowler-Nordheim (F-N) theory. <span style="mso-bidi-font-weight: bold">The results obtained indicate that field emission can be optimized when the inter bundle distance is comparable with the nanotube height. Field emission measurements carried out on vertically aligned CNT bundles grown on patterned substrates give a strong support to the results obtained by simulation. </span