Severity Assessment Scale Research Articles

Effect of Aerobic Training on Quality of Life in the Elderly with Idiopathic Chronic Fatigue

Objective: Idiopathic chronic fatigue (ICF) is described as clinically diagnosed physical and/or psychological chronic fatigue of more than 6 months, with no known/detected underlying pathologies/disorders. As no study has discussed the effect of scheduled, regular, and supervised aerobic exercise on fatigue severity, physical performance, and quality of life (QoL) in ICF elderly, this study was applied to achieve this aim. Material and Methods: Forty ICF elderly (from both genders) were divided evenly into the study group that received 8-week aerobic exercises plus traditional physical therapy balance and stretching exercises (n=20) and the control group (n=20) who received traditional physical therapy balance and stretching exercises only. The fatigue severity assessment scale (FSAS), The elderly’s Brief-Version Quality-of-Life Questionnaire (EBVQOLQ), six-minute walking distance (6MWD), and serum glutathione (as an anti-oxidative substance) were assessed. Results: Only the study group’s outcomes (EBVQOLQ, six minute walk distance (SMWD), serum glutathione, and FSAS) showed significant improvements. Conclusion: Eight-week aerobic exercises in ICF elderly can improve fatigue perception, physical performance/capacity, QoL, and anti-oxidative defense.

A study into the present situation and factors influencing post-traumatic stress disorder in patients affected by venomous snake bites in Guizhou, China

Objective: To examine the occurrence of post-traumatic stress disorder among patients who have experienced venomous snakebites and investigate the factors contributing to it. The results provided insights for devising suitable nursing interventions. Methods: Between June 2022 and October 2023, a total of 128 snakebite patients from the Advanced Snakebite Rescue Center at a tertiary hospital in Guizhou Province were chosen as participants using convenience sampling. General Information Questionnaire, the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), the Social Support Rating Scale (SSRS), the Visual Analog Scale (VAS), the Simple Clinical Severity Assessment Scale, and the Swelling Severity Rating Scale (SSRS) were assessed at the time of admission, and Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) at 1 month after. Results: The prevalence of post-traumatic stress disorder (PTSD) among patients bitten by venomous snakes was found to be 67.97%, with an average PTSD score of 44.26±13.53. Various factors including cultural background, psychological resilience, social support, pain intensity, severity of snakebite, and degree of swelling were identified as influencing PTSD in these patients (all P < 0.05). Conclusion: The incidence of PTSD was increased in individuals with venomous snakebites, particularly among those with lower literacy levels, reduced psychological resilience, limited access to social support, increased pain levels, severe snakebites, and significant swelling. Healthcare professionals should address PTSD in patients with snakebites and implement preventive interventions targeting these high-risk factors to mitigate the occurrence of PTSD in this patient population.

Validation of a Photonumeric Scale for Evaluation of Telangiectasia in Rosacea.

Telangiectasia is a prominent feature of rosacea leading to a high demand for effective treatment. To ensure consistent clinical and scientific evaluations and assess treatment response accurately, standardized assessment tools are necessary for grading the severity of telangiectasia. However, no validated grading scales for this condition are currently available. To develop and validate a photonumeric scale for assessing the severity of telangiectasia in rosacea patients. The five-point photonumeric Telangiectasia in Rosacea Severity Assessment (TRoSA) scale was developed for the severity of telangiectasia in rosacea. Sixteen experts participated in the validation process, evaluating 50 images of rosacea patients in two rounds. Interrater and intrarater reliability were analyzed using the intraclass correlation coefficient (ICC) and weighted kappa, respectively. Interrater reliability was found to be "almost perfect" in both validation rounds (Round 1: ICC 0.847; Round 2: ICC 0.828). The mean weighted kappa indicated "substantial" intrarater reliability between the two rounds with a weighted kappa of 0.719. A bubble plot of the two rounds illustrated a diagonal order, confirming the consistency of the intrarater agreement. The TRoSA scale demonstrated high interrater and intrarater reliability indicating that it is a consistent and reproducible tool for grading the severity of telangiectasia in rosacea. This scale can standardize clinical assessments, assisting in diagnosis, treatment planning, and evaluation of therapeutic efficacy.

Assessment and Monitoring of Adverse Drug Reactions at a Tertiary Care Hospital

Background: Incidences of adverse drug reactions were reported through spontane-ous reporting at an ADR monitoring unit in a tertiary care hospital. Aims: This study was conducted to describe the distribution pattern of adverse drug reaction (ADR). Objective: The objective of this study was to monitor and report the adverse drug reactions (ADRs) occurring in a tertiary care hospital and to evaluate the incidence, causality, severity, and preventability of adverse drug reactions. Methods: A prospective, observational study was conducted at a tertiary care hospital in Punjab for 6 months. All patients admitted to the hospital above 18 years of age were included in the study. Results: A total of 103 ADRs were observed over the study period of 6 months. The majority of them were females (60), comprising of 58.25%. The therapeutic class of drug associated with most of the ADRs was antibiotics 18 (17.5%). Maximum number of ADRs occurred in the gen-eral medicine ward with frequency of 27 (26.2%) and were of type b 58 (56.3%). Causality was assessed using the Naranjo scale, and most of the ADRs came out to be probable 64 (62.1%) in nature. Severity was assessed using Hartwig’s severity assessment scale, and most of the cases, 66 (64.1%), were moderate in intensity. ADR preventability was assessed using the Schumock and Thornton preventability scale, and it was observed that most of the cases, 82 (79.6%), were not preventable. Conclusion: This study seeks to strengthen the ADR database through analysis of spontaneous reporting patterns of ADRs from various clinical departments of a tertiary care teaching hospital, thereby increasing awareness and improving the reporting culture among health care practition-ers. It can be concluded that continuous medication monitoring and a well-organized and com-mitted pharmacovigilance system led by a clinical pharmacist in a hospital setting would un-doubtedly lower the incidence of adverse drug reactions.

An observational study on the spectrum of Cutaneous Adverse Reactions to Antitubercular drugs and their management

IntroductionTuberculosis (TB) remains a significant global health issue, ranking as the 13th leading cause of death worldwide. Management of tuberculosis requires administration of multiple drugs for varied duration which increases the risk of developing adverse reactions. Among various adverse reactions are cutaneous adverse reactions (CARs) which can be immune mediated or non immune mediated. Aim1. To study the clinical, epidemiological, and morphological characteristics of cutaneous adverse reactions resulting from antitubercular treatment. 2. To study the outcomes of cutaneous adverse reactions to antitubercular therapy using the Modified Hartwig and Seigel severity assessment scale and rechallenge protocol, and assess the effectiveness of management strategies. Methodology: A longitudinal observational study was conducted over a period of 1 year at department of Pulmonology and Dermatology at tertiary care institute to assess CARs in patients on antitubercular treatment. Rechallenge was done in eligible patients. ResultsAmong 3164 TB patients on anti-tubercular treatment (ATT), 56 developed CARs, yielding an incidence rate of 1.77% per year. The study found female preponderance, with the most affected age groups being 21-30 and 41-50 years. Most CARs occurred within the first 30 days of ATT initiation, predominantly manifesting as maculopapular rash. Factors such as multiple medication use, diabetes, elderly age, and positive HIV status were associated with CARs. Ethambutol was identified as the most frequently implicated drug in the occurrence of cutaneous adverse reactions (CARs) upon rechallenge. ConclusionEffective management of CARs involves appropriate treatment, careful monitoring, and rechallenge protocols to identify culprit drugs while minimizing the risk of severe reactions.Upon complete resolution of initial adverse reaction, one must do rechallenge meticulously to pinpoint culprit drug and ensuring effective tuberculosis treatment.

Adverse drug reactions and drug-related problems with supportive care medications among the oncological population

AimThe current study emphasizes the impact of adverse drug reactions (ADRs) and Drug-Related Problems (DRPs) caused by supportive care medications administered with chemotherapy.MethodThis is a longitudinal observational study carried out at the Ramaiah Medical College Hospital in Bengaluru, Karnataka, India, at the Department of Oncology. The data was recorded using a specifically created data collecting form. Based on the PCNE (Pharmaceutical Care Network Europe), DRPs are identified. The WHO probability scale, Modified Hartwig and Siegel for ADR severity assessment, Naranjo's algorithm for causality assessment, Rawlins and Thompson for predictability assessment, and Modified Shumock and Thornton for preventability assessment were all utilized. The OncPal guideline was considered in terms of the precision of supportive care medications regarding the reduction of ADRs in cancer patients.ResultWe enrolled 302 patients,166 (55%) female and 136 (45%) male (SD 14.378) (mean 49.97), patients with one comorbidity 59(19.6%) and multimorbidity (two or more) 45(14.9%), the DRPs identified were found to be 153 (50.6%); only P2 (safeties of drug therapy PCNE) were considered in this study. ADRs which are identified 175(57.9%) contributed/caused by the supportive care medications. WHO probability scale: 97 (32.1%) possible and 60 (19.9%) unlikely; Naranjo’s algorithm: 97 (32.1%) unlikely and 69 (22.8%) possible; ADR severity assessment scale (Modified Hartwig and Siegel): 95 (31.5%) mild and 63 (20.9%) moderates; Rawlins and Thompson for determining predictability of an ADR: 33 (10.9%) predictable and 137 (45.5%) non-predictable; and Modified Shumock and Thornton for determining preventability of an ADR: 81 (26.8%) probably preventable and 90 (29.8%) non-preventable. The statistical comparison through preforming t-test and measuring Chi-Square between group with ADRs and without ADRs shows in some variables, significantly (Alcohol consumption status, P = .019) and Easter Cooperative Oncology Group (ECOG) performance status P < 0.001.ConclusionComprehensive assessment of supportive medications in cancer patients would enhance the patient management and therapeutic outcome. The potential adverse drug reactions (ADRs) caused by supportive care medications can contribute to longer hospital stays and interact with the systemic anti-cancer treatment. The health care professionals should be informed to monitor the patients clinically administered with supportive medications.

Construction of an assessment scale for thirst severity in critically ill patients and its reliability and validity.

Developing a severity assessment scale for critically ill patients' thirst and conducting reliability and validity tests, aiming to provide healthcare professionals with a scientific and objective tool for assessing the level of thirst. Based on literature review and qualitative interviews, a pool of items was generated, and a preliminary scale was formed through two rounds of Delphi expert consultation. Convenience sampling was employed to select 178 ICU patients in a top-three hospital from May 2023 to October 2023 as the study subjects to examine the reliability and validity of the severity assessment scale for critically ill patients' thirst. The developed severity assessment scale for critically ill patients' thirst consists of 8 evaluation items and 26 evaluation indicators. The agreement coefficients for two rounds of expert consultation were 100% and 92.6% for the positive coefficient, and the authority coefficients were .900 and .906. Kendall's concordance coefficients were .101 and .120 (all p < .001). The overall Cronbach's α coefficient for the scale was .827. The inter-rater reliability coefficient was .910. The Item-Content Validity Index (I-CVI) ranged from .800 to 1.000, and the Scale-Content Validity Index/Average (S-CVI/Ave) was .950. The critically ill patients' thirst assessment scale is reliable and valid and can be widely used in clinical practice. The AiMi Academic Services (www.aimieditor.com) for English language editing and review services. The scale developed in this study is a simple and ICU-specific scale that can be used to assess the severity of thirst in critically ill patients. As such, the severity of thirst in critically ill patients can be evaluated quickly so that targeted interventions can be implemented according to the patient's specific disease and treatment conditions. Therefore, patient comfort can be improved, and thirst-related health problems can be prevented.

A clinical study to monitor prescription patterns, clinical outcomes, and adverse drug reactions among patients of various interstitial lung diseases attending respiratory medicine outpatient department at tertiary care hospital in Northern India.

The aim of this study was to monitor prescription patterns, clinical outcomes, and adverse drug reactions (ADR) among patients of various interstitial lung diseases (ILDs). This prospective study was conducted in the Department of Pharmacology and Therapeutics in collaboration with the Department of Respiratory Medicine, King George's Medical University, Lucknow, for a period of 12 months (October 2020-September 2021). A total of 77 patients were enrolled after satisfying the inclusion and exclusion criteria. The prescriptions were collected, and necessary details were noted on the case report form. After completion of the study, the data were analyzed for prescription patterns, clinical outcomes, and quality of life with the help of a validated questionnaire-King's Brief ILD (KBILD) questionnaire. At the same time, ADRs, if any, were assessed using Hartwig's Severity Assessment Scale and Naranjo Causality Assessment Scale. The most common ILD was acute/chronic hypersensitivity pneumonitis (HP). Average number of drugs per encounter was 4.45. Crepitations were the most common clinical signs. Clubbing and rhonchi were reported maximum in idiopathic pulmonary fibrosis. It was found that psychological, breathlessness and activities, chest symptoms, and total KBILD reduced significantly after 3 months as compared to baseline with a statistically significant difference as P < 0.01. ADRs were found in 23.38% (18) of the subjects. Maximum ADR reported was gastritis (9.09%), followed by hepatitis (3.90%). The high proportion of patients clinically diagnosed with HP in our study highlights the importance of a detailed environmental exposure history in the diagnostic evaluation of patients with ILD to avoid inaccurate diagnoses. ADR-related hospital admissions are a significant problem in the health-care system.

Australian consensus: Treatment goals for moderate to severe psoriasis in the era of targeted therapies - Considerations for paediatric patients.

Treatment goals have been established in Australia to facilitate the management of adults with moderate to severe psoriasis. The Australasian College of Dermatologists sought to determine if and how these adult treatment goals could be modified to accommodate the needs of paediatric and adolescent patients. A modified Delphi approach was used. Comprehensive literature review and guideline evaluation resulted in the development of statements and other questions to establish current clinical practices. Two rounds of anonymous voting were undertaken, with a collaborative meeting held in between to discuss areas of discordance. Overall, consensus was defined as achievement of ≥75% agreement in the range 7-9 on a 9-point scale (1 strongly disagree; 9 strongly agree). Consensus was achieved on 23/29 statements in round 1 and 17/18 statements in round 2. There was a high level of concordance with treatment criteria in the adult setting. The limitations of applying assessment tools developed for use in adult patients to the paediatric setting were highlighted. Treatment targets in the paediatric setting should include objective metrics for disease severity and psychological impact on the patients and their family, and be based on validated, age-appropriate tools. While the assessment, classification and management of moderate to severe psoriasis in paediatric patients aligns with metrics established for adults, it is vital that nuances in the transition from childhood to adolescence be taken into account. Future research should focus on psoriasis severity assessment scales specific to the paediatric setting.

ADVERSE DRUG REACTIONS OF BACLOFEN, NALTREXONE, AND ACAMPROSATE IN PATIENTS HAVING ALCOHOL DEPENDENCE: A CROSS-SECTIONAL PHARMACOVIGILANCE STUDY

Objectives: The research aims to investigate the prevalence and patterns of adverse drug reactions (ADRs), gauge the severity of these reactions, establish causality in ADR cases, and assess the preventability of such adverse reactions. Methods: ADR information was gathered through personal interviews with patients or their relatives. Causality was assessed using the Naranjo algorithm, and a modified Hartwig and Siegel Severity Assessment Scale was used for estimating the severity of ADR. ADRs were grouped into various preventability categories based on the modified Schumock and Thornton criteria. Results: The total number of patients evaluated in the baclofen, naltrexone, and acamprosate groups was 65, 28, and 42, respectively. The most commonly reported adverse events with baclofen were nausea (31.25%), followed by fatigue (18.75%) and headache (12.50%). The majority of patients receiving acamprosate reported nausea (57.14%), followed by diarrhea (28.57%). Patients receiving naltrexone most commonly reported nausea (35.71%), followed by abdominal pain (21.43%) and headache (14.28%). Conclusion: This study shed light on the prevalence, severity, causality, and preventability of ADRs associated with anti-craving agents used to treat patients with alcohol withdrawal syndrome, providing valuable insights into the safety profiles of these medications.

Adverse Drug Reactions at Primary Health Centres in Malaysia

Background: Adverse drug reactions can lead to a substantial economic burden on patients and the country. This study aims to analyze the pattern of adverse drug reactions and assess the causality of the adverse events and severity of adverse drug reactions in primary health centers in Malaysia. Methodology: This retrospective study used case series analysis and data from six Malaysian primary health centers. The patients were analyzed for gender, age, class of drugs involved, organ system involved in the adverse reaction, severity using Hartwig’s severity assessment scale and causality using the Naranjo ADR probability scale. Data were analyzed using descriptive statistics. Results: In 113 adverse drug reactions were reported. Cardiovascular drugs commonly caused adverse drug reaction (38%), followed by anti-infective agents (20%), skin and subcutaneous disorders were the common adverse drug reactions encountered (23%). The severity of the adverse reaction was level 2 in most patients (69. 9%). Adverse drug reaction was mostly found to be probable (48.7%), and 64% of the patients recovered from the adverse drug reaction. Conclusion: Cardiovascular drugs commonly cause adverse drug reactions. Level 2 and mild reactions were widely observed. The causality assessment was probable in most of the patients.

Дезадаптивные личностные, нейропсихологические и социально-психологические факторы у подростков с отклоняющимся самоповреждающим поведением

According to theoretical data, the propensity to self-injurious behavior is compared with addictive patterns based on unifying behavioral, mental and psychological factors within the framework of a clinical approach. Emotional regulation, cognitive functioning, features of deviant behavior, and socio-psychological characteristics in adolescents with self-harm, depending on the presence or absence of a suicidal goal, have been studied to a small extent so far. The Columbia Suicide Severity Assessment Scale, a questionnaire for the study of deviant behavior, a brief assessment of cognitive functions, and an emotional regulation questionnaire examined 156 adolescents with non-suicidal self-harm and 148 adolescents with suicidal behavior. The results of the study of the cognitive regulation of emotions convincingly indicate the presence of a pronounced cognitive-affective imbalance with a shift towards a deficit of effective strategies for overcoming emotional situations in adolescents with suicidal behavior. Adolescents with suicidal self-harm have a tendency to various manifestations of deviations. Affective interference, problem-solving behavior, operative memory, and emotion suppression are more impaired in adolescents with suicidal behavior compared to adolescents with non-suicidal self-harm.

Sağlık Çalışanlarında Ağrı Değerlendirme Tercihleri: Türkiye'den Bir Çalışma

Objective: Pain assessment of individuals with acute or chronic pain while creating a physiotherapy program is of great importance in demonstrating the effectiveness of the treatment. The aim of this study is to determine the pain assessment preferences of healthcare providers. &#x0D; Material and Method: We tried to reach different healthcare providers who are dealing with patients suffering from pain, living and working in Turkey via a Google survey. Healthcare providers (aged 18-60) with at least one year of work experience in their field were included. In the questionnaire, age, gender, profession, working time in the profession, institution, acute/chronic patient follow-up, pain severity assessment scale preference, and pain localization assessment preference were questioned. &#x0D; Results: A total of 159 healthcare providers (114 females and 45 males) participated in this survey and replied to the questionnaire. 54.7% of them reported that they preferred the Visual Analogue Scale (VAS), and 11.9% of them preferred the Verbal Rating Scale (VRS) to evaluate pain intensity. The participants preferred verbal feedback and palpation to determine pain localization. &#x0D; Conclusion: In this survey was conducted in Turkey, health providers’ preferences were found to be similar to the related literature. The results obtained from this survey also indicate that health providers working in Turkey mostly prefer VAS in pain intensity assessment.

Spontaneously reported adverse drug reaction pattern in a tertiary care teaching hospital: A cross-sectional study

Background: Adverse drug reactions (ADRs) are unintended and harmful reactions to medications that occur at doses normally used for therapeutic purposes. The reporting of ADRs is essential for the identification and prevention of ADRs. Aims and Objectives: The aim of the study was to estimate the frequency and distribution of spontaneously reported ADRs in the tertiary care teaching hospital. Materials and Methods: A retrospective cross-sectional study was conducted from July 2020 to June 2023, from spontaneously reported ADRs by the ADR Monitoring Centre, MGM Medical College, Kishanganj, Bihar. Distribution of age, gender, department, medication groups, and systems involved were examined. Utilizing certain scales, causality, severity, and preventability were evaluated. Results: Total 47 ADRs were reported during the study period. The most common ADRs were cutaneous ADRs (n = 19,40.43%) followed by the central nervous system (CNS) (n = 12, 25.53%), gastrointestinal system (GI) (n = 9, 19.15%), musculoskeletal (n = 4, 8.51%) and others. The most commonly implicated drugs were Antibiotics (21.28%) followed by analgesics (12.77%), DMARD (12.77%), antihypertensive (12.77%), and others shown in the study. The severity assessment of ADRs was done by Modified Hartwig et al. severity assessment scale and was found mild (87%), followed by moderate (8.5%) and severe (4.3%). Using the modified Schumock and Thronton preventability scale preventability assessment of ADRs was done and was found 51.06% of ADRs were definitely preventable, 38.30% were probably preventable and 12.77% of ADRs were not preventable. Conclusion: The findings of this study emphasize the significance of pharmacovigilance and the requirement that medical personnel be knowledgeable about the indications and symptoms of ADRs.

Ab. No. 119 Development of a Comprehensive Scale to Evaluate the Severity of Chronic Stroke: An Exploratory Study

Introduction: Stroke is the second leading cause of death and disability. To quantify the impairments caused by stroke there are various tools to evaluate the severity of signs and symptoms discretely and these tools are sensitive to assess acute and subacute stroke. But regardless of using different other tools to evaluate individual sign and symptom of stroke we can use a comprehensive tool. So to our knowledge there has been no study done where there is a comprehensive tool to evaluate the severity of chronic stroke. Therefore, development of an assessment tool which incorporates all the domains proportionately and collectively measure signs and symptoms of chronic stroke. This will be intriguing and helpful in planning treatment protocols based on the results obtained. Methods: The Severity Assessment Scale of Chronic Stroke (SASCS) was developed in 2 stages. Stage 1- Development of the scale included conceptualization and item generation. Stage 2- Expert review, Item modification and Identifying Content Validity Index. Results: The Content Validity Index of the domains was found to be 0.92 which indicates Strong Content Validity. Conclusion: The Severity Assessment Scale of Chronic Stroke (SASCS) is a comprehensive scale which may be suitable to evaluate all the domains proportionately and include the signs and symptoms with simple and feasible scoring within a given timeframe.

A Comprehensive Review of the Acne Grading Scale in 2023.

Acne is a common skin inflammatory condition that can significantly affect the patient's quality of life. Therefore, accurate assessment scales are very important for treatment and management of acne vulgaris. This review article issues a comprehensive review of various acne severity assessment scales. In this text, the authors review the acne grading scales, such as the Pillsbury scale, Cook's acne grading scale, Leeds acne grading system, Global Acne Grading System, and investigator's global assessment, etc. And we delve into the characteristics, advantages, limitations, and applicability of these scales. The acne grading scale to be developed in the future should be objective, accurate, comprehensive, easy to use, and applicable in a variety of clinics and research settings. Current technologies, such as artificial intelligence, could potentially contribute to the development of ideal acne grading scales that meet unmet needs.

CONTEMPORARY PERSPECTIVES ON DIAGNOSING ACUTE PANCREATITIS

Acute pancreatitis represents a significant challenge in urgent surgery. It holds a prominent position among urgent surgical diseases, with a rising incidence of severe, complicated forms. The increase in the negative outcomes of acute pancreatitis treatment is linked to delayed diagnosis of severe forms and their complications, owing to the absence of a highly effective severity assessment scale. This deficiency contributes to unjustified surgical interventions. Early severe pancreatitis manifests with a rapidly progressive course leading to organ failure, hypoxia, necrotic foci formation, abdominal sepsis, and abdominal compartment syndrome. Specific scales for early diagnosis include the criteria scale for primary assessment of acute pancreatitis severity, the Ranson scale, and the BISAP scale. The modern diagnosis of severe acute pancreatitis relies on two key international classifications: the Revised Atlanta Classification (2012) and the Determinant-based classification (2012). To assess the intensity of pancreatic inflammation by CT scan, the Balthazar scale is used, which is included in the Computer Tomography Severity Index and enables to determine the area of pancreatic necrosis.&#x0D; The purpose of this study is to improve the diagnosis of acute severe pancreatitis.&#x0D; The study was carried out by assessing the medical records of 20 patients diagnosed with acute pancreatitis who received treatment at the Surgical Inpatient Department of the 2nd City Hospital, Poltava, from 2021 to 2022.&#x0D; The analysis revealed that conducting a computer tomography within the 48-72 hours from the onset of the disease enables a comprehensive assessment of its severity. This assessment significantly influences the subsequent treatment approach, reducing the necessity for surgical intervention and lowering the risk of patient mortality.&#x0D; Hence, in alignment with contemporary classifications and diagnostic perspectives on acute pancreatitis, MSCT assumes a pivotal role, significantly influencing the selection of treatment strategies in all cases. This inclusion facilitates timely surgical interventions and allows for adjustments to conservative therapy based on the severity of pancreatic inflammation. It is advisable, however, to conduct computed tomography 48-72 hours after the onset of pain to adequately assess the pancreatic condition. Morphological changes in the pancreas typically do not manifest within the initial day of the disease, making early CT diagnostics potentially misleading regarding the true state and severity of acute pancreatitis.

Clinical profile of medication-related emergencies among patients presenting to the emergency department: An observational study

Objective: To determine the clinical profile of patients presenting with medication-related emergencies to the Emergency Department of our institute. Methods: This was an observational study conducted between November 2018 and September 2020 at Bangalore Baptist Hospital, Karnataka. A total of 138 subjects who satisfied the inclusion criteria were included in the study. The severity of adverse drug reactions (ADR) is assessed based on the Hurwitz severity assessment scale of ADR. Glasgow coma scale at the time of presentation and source of medication were noted. The type of drug overdose, requirement of advanced airway and vasopressors, and the outcome were also assessed. Results: Among medication-related emergencies (n=138) in our study, ADR contributed to 70.3% (n=97) of the study population, and drug overdose accounted for 29.7% (n=41). One-third of the ADR occurred in patients aged above 60 years. Most patients were hemodynamically stable and did not require vasopressors, or advanced airway in both groups. Most patients had Glasgow coma scale ranging from 13-15 in both groups. Nonsteroidal anti-inflammatory drugs were the most used medicine (17/41, 41.5%) and most medications were over the counter drugs (25/41, 61.0%) in the drug overdose group; meanwhile in the ADR group, anti-diabetic medication was the most used medicine (34/97, 35.1%) and most medications were prescribed in the ADR group (93/97, 95.9%). Conclusions: Our study shows that ADR is the most common type of medication-related emergency.

PROFILE OF CUTANEOUS ADVERSE DRUG REACTIONS IN PATIENTS ATTENDING THE DERMATOLOGY OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL, GANGTOK

Objectives: The present study was undertaken to evaluate the frequency of occurrence of cutaneous adverse drug reactions (ADRs) in patients attending dermatology outpatient department (OPD) and to assess causality and severity of the reported cutaneous ADRs, using different scales. Methods: The study involved descriptive through retrospective review of patient medical records for patients who attended dermatology OPD for a period of 9 months. Patients’ records specifying with cutaneous ADRs were taken for the study. Results: The record of 30 patients reported with cutaneous ADRs with certain exclusions was studied. Higher incidence was found among females with 20–40 years of age. The most common presenting symptom was found to be erythematous rash (33%) and the drug groups involved in reactions were NSAIDS, beta-lactams, antitubercular drugs, and antifungals (16.7% each). The most common drug associated with cutaneous ADRs (CADRs) was itraconazole and aceclofenac (16.7% each). On the Naranjo scale, 86% reactions were labeled as “possible” while others as “doubtful”. All the reactions were labeled as mild on Hartwig’s Severity Assessment Scale. Conclusions: Lack of post-treatment follow-up could be a reason for the difference in the causality result as compared to other studies. The data recorded in this study can be utilized as reference for future studies with large population.

Incidence of Adverse Drug Reactions (ADRs) and their Determinants among Sputum-Positive Pulmonary TB Patients in A Metropolitan Area, Bengaluru: A Prospective Study

Background: India accounts for 2.42 million new Tuberculosis cases in 2022. Treatment adherence is major challenge, ADRs being one of the main causes of poor adherence. Early identification and addressing of ADRs can improve adherence, reducing associated morbidity and drug resistance. With introduction of daily FDC regimen in India, we intend to study incidence of ADRs and their determinants among Pulmonary TB patients who are on FDC daily regimen. Methodology: Newly diagnosed drug-sensitive PTB patients aged 18 years and above were recruited. A pretested questionnaire was administered and patients were followed up to document ADRs. Causality and severity were assessed using the WHO-UMC scale and Hartwig’s severity assessment scale respectively. Results: Among the study participants’, 95 (78.5%) developed any ADRs. Incidence rate was 13.2 (6.98–19.22) per 100-person month follow-up with GI symptoms being most common. Increasing age [OR=4.7(1.6–14.8)] and weight [OR=5.1(1.3–16.2)] were found to be significantly associated with ADRs. All ADRs were classified as ‘probable’ and ‘mild’ in nature according to WHO scale and Hartwig’s severity assessment scale respectively. Conclusion: Occurrence of ADRs is common, most of them are mild, and occurring in intensive phase. Hence, early identification and appropriate counselling during intensive phase is critical.