A CASE REPORT OF ZIDOVUDINE-INDUCED THUMBNAILS HYPERPIGMENTATION IN AN HIV POSITIVE PATIENT WITH SECONDARY HERPES ZOSTER OPHTHALMICUS INFECTION

Zidovudine is one of the first-line antiretroviral therapy regimen drug used to treat human immunodeficiency virus infected patients. Nail pigmentation associated with zidovudine therapy is seen in adults and children’s, mainly dark-skinned patients. This case attempts to draw attention among healthcare professionals concerning the non-serious adverse effect of nail pigmentation with zidovudine. In our case, the patient was counseled about this adverse effect without any change in zidovudine therapy. Even though this side effect is harmless and reversible, the psychological aspects of this visible side effect may reduce medication adherence and can also result in inessential investigations and management for misdiagnoses such as cyanosis and melanoma

A RARE PEDIATRIC CASE OF CHRONIC ARSENIC POISONING FROM AYURVEDIC MEDICATION

Ayurveda is an indigenous system of medicine becoming more popular around the world in recent years. In various Ayurvedic formulations, the arsenical compounds are intentionally added as the main active ingredients or as an auxiliary agent to assist the efficacy of herbal drugs. The chronic arsenic poisoning following the use of Ayurvedic medication is reported rarely in the literature. This report describes a rare pediatric case of chronic arsenic poisoning from Ayurvedic medication in a 15-year-old girl. She was a known case of seizure disorder and was on treatment with Ayurvedic medication for 1 year. The generalized hyperpigmentation and thickening of soles were noticed in the girl 7 months after taking the herbal tablet. The plasma-coupled atomic absorption spectroscopy of herbal tablet was performed in a laboratory and the result showed 4.3 mg of arsenic present in each herbal tablet. The patient was advised to stop the Ayurvedic medication and as an alternate drug, tablet levetiracetam (250 mg, twice a day) was started for the treatment of seizure disorder. During the follow-up, her cutaneous manifestations improved and is doing well

ROLE OF ANTIDEPRESSANT ON THE GLYCAEMIC CONTROL OF UNCONTROLLED TYPE 2 DIABETES MELLITUS PATIENTS

Background: Depression incidence is higher in diabetic patients when compared to the non-diabetic individuals and there exist a two-directional relationship between depression and the development of type 2 diabetes mellitus. Objectives: This study aimed to estimate the frequency of depression and the effect of antidepressant on glycemic control in type 2 diabetes mellitus patients. Methods: This prospective interventional study was conducted in type 2 diabetes mellitus patients with a sample size of 100. These patients were diagnosed with depression using WHO-ICD10 criteria. All study patients had uncontrolled blood glucose levels and were on an optimized maximal dose of combination oral hypoglycemic agents with stable glycoregulation (HbA1c 8.4 ±0.5) were taken up for the intervention with antidepressant. These patients were started on with antidepressant after enrollment and followed up for fasting blood sugar (FBS), post-prandial blood sugar (PPBS), and HbA1c at the end of 3 months and 6 months. And also Hamilton depression rating scale scores were estimated at the beginning of the study and at the end of 6 months. Results: The frequency of depression among the type 2 diabetes mellitus patients was found to be 42%. There were reduction of mean FBS levels from baseline value of 177 mg/dl to follow-up value of 160 mg/dl (p<0.001), mean PPBS levels from 251.16 mg/dl to 217.84 mg/dl (p<0.001), and mean HbA1c dropped from 8.41 to 7.57 (p<0.001) after the treatment with antidepressant. Conclusion: Our study concluded that patient started on antidepressant showed a reduction in the blood sugar levels and HbA1c levels from their baseline values, which was clinically and statistically significant

WHICH SYRUP FLAVOR PEDIATRIC POPULATION PREFERS THE MOST?

Objectives: To find out syrup flavor preferences among pediatric patients. Methods: This prospective survey included 350 pediatric patients in a multispecialty hospital and was conducted for over four months. The patients filled a pro forma with a questionnaire regarding the syrup flavor preferences details among four drug categories. If the patients were unable to fill the questionnaire, the parents were asked to fill the same. Results: In our survey, the first preference of the syrup flavors by male gender from all four drug categories were banana-vanilla, orange, lime, and orange-lemon flavors. Whereas, the same in the female gender were the following: Strawberry, grape, banana-pineapple, and strawberry-lemon flavors. Conclusion: The creation of an acceptable syrup taste using flavors should be taken into account by the healthcare professionals before prescribing it to the children

A PILOT STUDY ON IDENTIFICATION AND MANAGEMENT OF DRUG INDUCED SEXUAL DYSFUNCTION: A COLLABORATIVE APPROACH BY CLINICAL PHARMACIST AND PSYCHIATRIST: IDENTIFICATION AND MANAGEMENT OF DRUG INDUCED SEXUAL DYSFUNCTION

Objective: To assess the role of clinical pharmacists in the identification and management of drug-induced sexual dysfunction in collaboration with the psychiatrist and also to determine the prevalence and pattern of drug-induced sexual dysfunction, identify nature and extend of drug-induced sexual dysfunction, and assess the pattern of management of drug-induced sexual dysfunction. Methods: This periodic prevalence interventional study was carried out among patients who visited the psychiatric department of a university hospital over three month’s period. Patients were screened for sexual dysfunction using the Arizona Sexual Experience Scale (ASEX) by study pharmacists. Results: Of the 100 patients reviewed, only 50% of subjects met the study criteria. Depression (42%) was the most common clinical diagnosis among the study patients. The overall prevalence of drug-induced sexual dysfunction was 16%. A higher incidence of drug-induced sexual dysfunction was observed in men (62.5%). Decrease libido (40%) was the most prominently observed drug-induced sexual dysfunction in both genders. Antidepressant (50%) was the most common class of drugs implicated in sexual dysfunction. Drug-induced sexual dysfunction was pharmacologically managed with vaginal lubrication (40%), Tadalafil (20%) and Tadalafil+Dapoxetine combination (40%). Conclusion: With this study, provided a vision, further how prospective studies in this arena may be carried out for better understanding drug-induced sexual dysfunction and how a clinical pharmacist can contribute for better health care of patients in the sex clinic by collaborating with medical practitioners