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Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Drug utilization evaluation is employed to assure quality care by assessing the appropriateness of drug therapy. The purpose of the study is to evaluate the drug use that will help to ensure that medicines are used appropriately and thus improving patient care and outcome. It was a prospective, observational study conducted in a tertiary care multispecialty hospital in Trivandrum. The duration of the study was six months. A total of 110 diabetic patients were evaluated during the study period. Out of these patients, 42 were males and 68 were females. It was recorded that 59.09% of participants had a family history of diabetes. Total 278 anti-diabetic drugs were prescribed. In which 130 drugs were prescribed as monotherapy, 71 drugs as the two-drug combination and 6 drugs as a three-drug combination. Metformin was the only antidiabetic drug that was commonly prescribed in both monotherapy and in combination therapy. Most of the patients had comorbid condition along with diabetes in which hypertension was most prominent. This study reveals that Metformin continues to be the best choice of the oral hypoglycemic agent with least adverse effects and the pattern of anti-diabetic prescription was largely comply with NICE guidelines. Key Words:- Drug utilization, anti-diabetic, Metformin, Nice – guidelines .

Pyoderma gangrenosum (PG) is a rare, destructive inflammatory skin disease which is painful and possesses rapidly progressive nature. It has life – threatening complication and devastating outcomes. The pathogenesis remains unknown and is not a bacterial infection; hence it does not possess infectious pathology but is referred to as a rare neutrophilic dermatosis with high levels of recurrent skin destruction. The disease progression can be controlled by the use of systemic corticosteroids and cytotoxic agents. Here we are reporting a case of 74 year old male patient suffering from sepsis and other comorbidities who was diagnosed with pyoderma ganrenosum by ruling out other possible causes of edematous skin lesion and purple discoloration, indicating the difficulty in the diagnosis of the condition. The patient responded to systemic corticosteroid treatment. PG causes significant morbidity to those it affects and no standardized treatment protocol exist to counteract this condition. Hence, further research is needed into the disease pathogenesis, and adequate targeted treatment. Key Words:- Pyoderma gangrenosum, necrotizing fasciitzing, skin discoloration, neutrophilic dermatosis.

Tuberculosis of spine or TB spine or spinal TB was first described by Percivall Pott. He noted this as a painful kyphotic deformity of the spine associated with paraplegia, hence the condition is also referred to as Pott’s disease or Pott’s spine. It is also called vertebral tuberculosis. Since tuberculosis is also called Koch’s lesion, the term spinal Koch’s is also used. Another term used is caries spine or spinal caries. Pain, neurological deficit, cold abscess, and kyphotic deformity are the characteristic features of spine koch disease. CBC, ESR, CT, MRI, and biopsy can help in its diagnosis. A 70-year-old female patient was diagnosed with spine Koch's disease and was treated with ATT4, posterior percutaneous transpendicular fixation and was advised for complete bed rest. Key Words:- Spine Koch’s Disease, Potts Disease, Tuberculosis.

Background: Hemodialysis is a common medical disorder. It has significant impact on HRQOL and the value of resources that are expended as a result of on ill health, Hypertension is associated with elevation of arterial BP. The management basically focuses on use of antihypertensives. Objectives: To determine and assess management of hypertension in hemodialysis patients. Methods: It was a Hospital based observational, prospective study conducted by random selection of patients. Based on the diagnosis the study populations were 70patients with hypertension on hemodialysis. Patients were included in the study after obtaining verbal informed consent. Information was collected about management of diseases, demography, diagnosis, treatment cured by patients was collected. Results and Discussion: Among 70 patients with hypertension on hemodialysis 78.5% patients were male and 21.5% were female. The most affected age group was between 36-45. The commonly prescribed drug was calcium channel blockers. The most preferred route of drug was oral. Key Words:- Hypertension, Hemodialysis, Pre-Hemodialysis blood pressure, Post Hemodialysis blood pressure

The main aim of the study is to report the drug related problem occurred in order to prevent its recurrence. A 23 year female patient presented with complaint of generalized swelling of body since 8 days, breathlessness since 3 days and fever since 3 days. She is Known case of seropositive inflammatory arthritis since last 1 year and taking prednisolone 20 mg b.i.d. She was having tachycardia, oedema, moon shape face. Her serum cortisol level is elevated and anti CCP antibodies were present hence diagnosed as prednisolone induced cushingoid syndrome with seropositive inflammatory arthritis. She was treated with Inj. Furosemide 4o mg IV b.i.d., Neb. Budesonide + Salbutamol every 6 hourly, Tab. Hydroxychloroquine 200 mg PO b.i.d., Tab. Methotrexate 15 mg PO Once a week, Tab. Calcium carbonate 500 mg PO o.d. and other symptomatic treatment. The prednisolone was withdrawn in tapered manner. Key Words:- Prednisolone, Cushing’s syndrome, inflammatory arthritis.

Background: An estimated 33 million people are living with human immunodeficiency virus (HIV) and around 3 million people have access to highly active antiretroviral therapy (HAART) worldwide. The introduction of HAART has led to a significant reduction in AIDS-related to the morbidity and mortality. Like most medicines, antiretroviral drugs can cause side effects, but are often mild & sometimes they are more serious and can have a major impact on health or quality of life. To evaluate this study is undertaken. Methodology: This study was conducted based on the review of clinical records of adult patients obtained from the ART center. Any selected adult patient on ART who fulfilled the inclusion criteria of study subject was enrolled. Results: In the study 64.78 % of patients showed at least 1 ADR and Skin rash and anemia complaints and in other patients, ADRs were moderate and need just symptomatic treatment. Conclusion: To optimize adherence, physicians must focus on early detection and prevention of ADRs, when possible and distinguishing those that are self-limited from those that are potentially serious. Our study finding showed that there is a need for active Pharmacovigilance with intensive monitoring for ADRs by treating Physician and Pharmacist in Indian HIV patients on HAART who are illiterate, with CD4 count ≤250 cells/mm3 with co-morbid conditions. Key Words:- Human immunodeficiency virus (HIV), Highly active antiretroviral therapy (HAART), Adverse drug reactions.

Whole medicines having a side effects and no one is without question baring of side effects or adverse effects of drugs recommended of patients and they should have to be careful and along acceptable hazardous or useful proportion. And the world health organization implemented the drug safety as the science deals related to pharmacological action, like an assessment, understanding and detection and patient safety and efficacy and other medicine relevant issues, additionally herbs components. Aim and objectives: The antagonist regimen chemical response appearing in ADRs assessment interior point in Chennai examination willing experiences all along 6 months. To develop and continue the pharmacovigilance on medicines to improve the safety and efficacy to provide better health for patients. Methods and materials: Study about assessment of adverse drug reactions documents were observational and prospective, whichever were performed betwixt august 2017 to January 2018. And this research work initiated with the authorize confirmation of Indian pharmacopoeia commission and as well as pharmacovigilance program of India, it have been considered as methodological and genuine hold up for research work in the triennial hospital in Chennai. Result: In the time duration of this research, to the majority of admitted patients and non hospitalized patients being present were 350 information captured from the department of medical record, amongst the patients data 195 adverse drug reactions was acknowledged. And moreover, 156 individual case safety reports (ICSRs) (0.021) was resulted by ICSRs. Discussion: Combined achievement through bygone 100 inhabitant’s nations into the PvP has been supported the world health organization universal data information of suspicious adverse drug reactions, whichever have been 1.2 lakhs individual case safety reports. In addition national data information, all sum of 33,023 individual case safety reports are resulted from an assortment of ADR monitoring centers and as well as pharma industries from august 2017 – January 2018, based on monthly improvement result according to pharmacovigilance program and Indian pharmacopoeia. Conclusion: The duration of our study discovered the prevalence of adverse drug reactions documenting into this ADR monitoring centers are inconsequent, while comparison with the resulted through ADR monitoring centers. The prevalence of adverse drug reactions documented through many types of data captured and data flow process transversely the universal are 5% - 25%, while in our nation that was above the 4%. Key Words:-ADRs, ICSRs, Patient safety and efficacy.

Cancer is a disease which affects not only patients but also their families physically and emotionally. The purpose of the study was to determine the psycho-social aspects like depression, anxiety, stress, etc., in cancer patients. In this study, a cross sectional approach was used. Data were collected through individual interview by using well designed questionnaire after obtaining proper consent. The study sample comprised of 243 patients. The study findings are grouped under age, gender, and psycho-social aspects such as financial hardship, stress, depression, loss of appearance, loss of interest in usual activities, disease knowledge and its prevention, out of 243 study population 120 were females and 123 were males. Among 243 study population 161 patients were majorly stressed, 66 patients were moderately stressed and 17 patients were suffering from minor stress. Psycho-social aspects in which patients were suffering majorly with stress 74.89%, depression 83.9%, financial hardship 79.83% and misconceptions 52.12%. In our study out of 243 patients, majority of the cancer patients (66.2%) were suffering with psycho-social distress and 77.3% patients were relieved from the distress after obtaining counselling.

 

Key Words:-Psycho-social aspects, distress, cancer, impact of psycho-social aspects, psycho-oncology.