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

Active surveillance of adverse events following COVID-19 vaccines in a tertiary care hospital

Background: Vaccination is a safe and effective way to prevent disease and save lives, but it may also produce some undesirable adverse events (AEs)which may affect healthy individuals. Therefore, the monitoring of AE following immunization (AEFIs) is necessary. The objective of this study was to assess the AEs following COVID-19 vaccinations in a tertiary care hospital. Methodology: The study was conducted as active vaccine safety surveillance for a period of 6 months among the COVID-19 vaccine beneficiaries of the study site. Active surveillance was conducted via initiating two telephone contacts. The first surveillance was conducted in 8 days and the second surveillance after 28 days of post-vaccination. All identified AEs following immunizations (AEFIs) were reported and analysed by the AEFI investigation team at the study site. The causality assessment of each identified AEFI was performed using the World Health Organization’s causality assessment algorithm. Results: A total of 2927 enrolled study population completed the study with a response rate of 80.85%. The study identified 902 AEFIs from 614 study populations with an incidence rate of 20.97%. Of which 794 and 79 AEFIs were associated with COVISHIELD™ and COVAXIN ® , respectively. The majority of the events were reported among the age group of 18–29 years. Overall, only three events were serious and no deaths were reported among the study population. A total of 75.59% of events had a consistent causal association with vaccination and were categorized as vaccine product-related reactions. The study identified various factors such as gender ( p  = 0.019), age ( p  < 0.05), co-morbid status ( p  = 0.032) and dose number ( p  = 0.001) as potential predictors for development of AEFI. Conclusion: The study identified only 0.33% of events as serious, and 99.67% of the study population recovered from the AEFIs, which reveals that COVISHIELD™ and COVAXIN ® have a generally favourable safety profile. However, close monitoring is required to identify the potential signals, as the safety data from the clinical trials are limited

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