Purpose: Human immunodeficiency virus-infected patients do not adhere to their antiretroviral therapy (ART) due to adverse effects of drugs. The continuous monitoring of adverse drug reactions (ADRs) may ensure the safe use of drugs in patients. Hence, a retrospective analysis was carried out to assess the ADRs pattern, causality, and severity associated with various antiretroviral drug regimens in patients receiving ART. Materials and Methods: A retrospective, analytical study was carried out at ART nodal center in Sri Venkateswara Ramnarain Ruia Government General Hospital, Tirupati. Data were collected by spontaneous reporting of health-care professionals from ART centers using Suspected ADR Reporting Forms of Indian Pharmacopoeia Commission to record the ADRs occurred in the patients who underwent treatment from December 2015 to November 2016. A total of 299 ADR reports were collected during the study period. The causality and severity of the reported ADRs were assessed using suitable scales. Results: From a total of 299 ADR reports, females (63.81%) experienced higher ADRs than males (36.12%). The highest number of ADRs was reported to zidovudine/lamivudine/nevirapine (ZLN) regimen (76.92%) than tenofovir/lamivudine/efavirenz (TLE) regimen (23.07%). Cutaneous reactions were higher (34.34%) among patients receiving ZLN therapy, and drowsiness (53.62%) was the most common ADR in patients receiving TLE regimen. According to the World Health Organization causality assessment scale, most of the ADRs were possible (75.92%). On the assessment of Modified Hartwig and Siegel Severity Scale, 55.09% of ADRs were moderate. Conclusion: The study showed an increased incidence of ADRs to ART which calls for efficient pharmacovigilance systems to improve patient care and drug safety.

Background: Prescribing to the older people is challenging. Pharmacokinetics and pharmacodynamic changes, chronic diseases, polypharmacy prescribing, potentially inappropriate medication (PIMs) prescribing, medication errors, adverse drug reactions, drug interactions, inappropriate prescribing or suboptimal prescribing are causes for challenge. It may lead to non-adherence, increase morbidity, length of hospitalization, poor quality of life, and finally death may occur. Method: A Prospective observational study was conducted in General Medicine department, for a period of 6 months. Patients of either gender who are above 65 years of age in general medicine in-patient ward with or without co-morbidities were included in the study; we excluded seriously ill and patients unable to communicate and Patients unwilling to participate in the study. Results: Total 140 geriatrics patients were admitted. In this study we observed that almost all prescriptions were with polypharmacy. PIMs observed from Beers criteria (17) and less in PRISCUS list (10). From both the lists 4 PIMs observed as same medications. Totally in 140 patients, 101 patients prescriptions were free from the PIMs, rest of the all potentially inappropriate prescriptions (PIPs). Conclusion: Inappropriate prescribing in geriatric patients is highly prevalent.

Objective: The objective of the study was to assess the drug-related problems (DRPs) and the World Health Organization (WHO) core prescribing indicators among stroke patients. Methods: A prospective observational study was conducted among stroke inpatients of Acute Medical Care and General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data about demographics, clinical characteristics, WHO prescribing indicators, and DRPs. Descriptive statistics were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Chi-square test was employed to test the significant association between the demographics and the occurrence of DRPs. Results: Among 174 patients included in the study, 89 had one or more DRPs. A total of 122 DRPs were identified in the study population. Drug interactions (48.4%) and adverse drug reactions (ADRs) (17.2%) were commonly observed DRPs. A significant direct association was observed between the occurrence of DRPs and number of comorbidities (p<0.001), polypharmacy (p<0.001), and hospital stay (p<0.05). The average number of drugs per prescription was 7.2. Of drugs prescribed, 67.6% were in their generic names. The percentage of encounters in which an antibiotic, injection was prescribed was 65.5% and 89.6% respectively. The percentage of drugs prescribed from an essential drug list was 91.2%. Conclusion: The rate of drug interactions and ADRs was high in treatment of stroke patients. Patients suffering from comorbidities, polypharmacy, and long hospital stay were positively associated with occurrence of DRPs in stroke. Regular monitoring and screening for drug interactions and ADRs were advised to reduce the burden DRPs in stroke patients admitted in a critical care unit.

Gynaecomastia in simple terms means development of breast in the males. This may be associated with various clinical conditions in men depending on the age at the time of diagnosis and may be due to intake of certain drugs that have the potential to cause breast enlargement. In HIV positive individuals Antiretro viral agent's intake was associated with development of breast tissue in males with efavirenz being one of such drugs. We report a case of efavirenz induced gynaecomastia in 37 year old male seropositive patient.

Hematohidrosis is a rare clinical condition in which an individual sweats blood. Even though there are several causes, such as systemic diseases, vicarious menstruation, extreme physical activity, psychogenic reasons, and idiopathic causes, acute fear and intensive mental pondering are the most frequent. Bloody perspiration, bloody tears (Hemoclaria), bleeding from the nose, bleeding from the ears (Otorrhoea), and leaking blood from various skin surfaces are all indications and symptoms of this condition. Here, we present a case of hematohidrosis in a 9y old female child with bleeding for two months from her forehead, nose, ear, and vagina, who responded to propranolol.