INCIDENCE AND MANAGEMENT OF TREATMENT-RELATED SIDE EFFECTS FOR PATIENTS RECEIVING PLATINUM THERAPY IN AN OUTPATIENT ONCOLOGY CLINIC

  Objective: Platinum agents (PAs) are the most commonly used chemotherapeutic agents, aiming to induce tumor cell death by cytotoxicity. This leads to have high potential for toxicity and adverse effects. The main objectives of this study were to describe the incidence of side effects caused by platinum therapy and to conclude the management of treatment-related side effects for patients receiving platinum therapy.Methods: A descriptive, retrospective study was carried out over a period of 9 months. Laboratory reports of 100 cancer patients were recorded. All statistical analyses were performed using SPSS 17.0 and GraphPad Prism. A p<0.05 (95% confidence interval) was considered significantly throughout the study.Results: Among 100 patients 55% were male and 45% were female. A total of 70% (n=70) patients who received platinum compounds as chemotherapy regimen, among them 97.14% (n=68) patients appears to have anemia. Among the occurrence of adverse drug reactions, the incidence of anemia was found to be significant (n=68, 97.14%). Statistically significant difference was found in the incidence of anemia between PAs and non- PAs treated group (p=0.0001).Conclusion: Among PAs cisplatin-induced anemia and nephrotoxicity appears to be high in this study. There is a need to improve the management of anemia induced by PAs. Since anemia is preventable, this study emphasizes the need to improve the management of anemia induced by PAs

A study on seroconversion rate following hepatitis B vaccination in chronic kidney disease population with current immunization strategy.

INTRODUCTION : Hepatitis B virus (HBV) infection is an important health problem worldwide and more so with chronic kidney disease patients. More than two billion people are infected with Hepatitis B virus all over the world and about 350 million people are chronic carriers. The prevalence of HBV infection is high in haemodialysis population compared to general population in view of increased exposure to blood products, contamination through needles and haemodialysis machine surface contamination. However with the availability of Hepatitis B vaccination, usage of erythropoietin and screening of blood products, dedicated machine with universal precautions the incidence of HBV infection is reduced in this population. Still HBV infection is a persistent problem and the immune response to vaccination is impaired.The seroconversion rate following Hepatitis B vaccination in healthy individuals is morethan 90% but in patients undergoing haemodialysis it is about 50% -60%. The centre for disease control (CDC) and prevention recommends Hepatitis B vaccination for patients with chronic kidney disease not requiring dialysis 3 doses at 0,1 and 6 months with 20 μg of each dose and for patients undergoing dialysis 4 doses at 0,1,2 and 6 months with 40 μg. This study was done to measure the antiHBS antibody titre following 4 doses of 40 μg of Hepatitis B vaccine in haemodialysis patients and compare with 3 doses of 20 μg in healthy controls. AIMS AND OBJECTIVES : 1. To find out the sero conversion rate following hepatitis B vaccination in Chronic kidney disease population with current immunization schedule and compare it with adult healthy volunteers. 2. To analyze the impact of various factors on immune response following hepatitis B vaccination. 59 CONCLUSION : 1. The seroconversion rate in chronic kidney disease Stage-V patients undergoing haemodialysis following 4 doses of 40μg of recombinant hepatitis B virus vaccine in our study was 82%. 2. The seroconversion rate in healthy adult volunteers with 3 doses of 20μg recombinant HBV vaccine in our study was 100%. 3. Female patients undergoing dialysis showed better immune response than males. 4. Non diabetic patients showed better immune response than diabetic patients. 5. Patients with higher body mass index had higher seroconversion rate than patients with malnutrition. 6. Patients with higher haemoglobin level had better response. 7. Adequately dialyzed patients were found to have better immune response. 8. Age,duration of dialysis and serum albumin had no impact on immune response following HBV vaccination

The Risk Factors and Outcome of Fungal Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patients

Aim: To determine the risk factors and outcome of fungal peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients over a 7-year period. Patients and Methods: This retrospective study was conducted on 30 cases of fungal peritonitis in CAPD patients during a 7-year period (2000-2007). The diagnosis was based on elevated CAPD effluent count and isolation of fungi. Patients were evaluated for previous episode of bacterial peritonitis. Results: The incidence of fungal peritonitis was 16.2%. Age varied between 8 and 75 years, with a mean age of 57 years. Twenty-three were males (76.7%) and seven were females (23.3%). Seventeen patients (56.6%) had previous episodes of bacterial peritonitis that was treated with multiple antibiotics. The common fungus was Candida species (50%). CAPD catheter removal and initiation of antifungal therapy was done for all patients. Reinsertion was done for three (10%) patients. Mortality rate was 20%. Conclusion: Patients with previous bacterial peritonitis and antibiotic usage are at greater risk of developing fungal peritonitis