Pharmacovigilance has gained significant importance with increased number of drugs molecules entering the market and the increase in the number of drug recalls due to the involvement of high health risks incident. It has become a critical phase in clinical development program to improve patient care and safety in relation to the use of medicines and also all medical and paramedical interventions. It also contributes to the assessment of benefits, harm, effectiveness and risk of medicines and encouraging their safe, rational and more effective drug use. India rates below 1 % in pharmacovigilance as against the world rate of 5 %, where pharmacovigilance is a fundamental driving principle in safeguarding public health. Due to the high profile issues with drug safety have highlighted the need not only to improve post marketing pharmacovigilance but also to identify drug candidates with good safety or benefit profiles. There are many challenges and barriers in the pharmacovigilance process which are from health professional like lack of training or awareness, due to self medication from patients, counterfeit drugs etc. which could be overcome by monitoring each patient using certain drug during the treatment by follow ups and emphasize on medication reconciliation during periods of care transition, including admission and discharge and subsequent follow up in the ambulatory settings.

Background: Drug related effects may lead to hospitalization, patient suffering and economic burden. Adverse Drug Reaction (ADR) monitoring and reporting system helps in detection and prevention of reoccurrence of some common and also rarest adverse drug reactions. The objective of this study was to create awareness among the selected community pharmacists and to improve their level of understanding about monitoring and reporting of adverse drug reactions to the pharmacovigilance centre around the facility. Method: The resent prospective study was conducted in hundred community pharmacists (chain & private pharmacies) for a period of nine months in and around Bangalore city. The aim of our study was to create awareness in select community pharmacists about the adverse drug reactions by presenting visual presentation, displaying awareness posters at each pharmacies and distribution of yellow cards. Results: All the 100 respondents showed 100% response about the knowledge of ADRs, where to obtain the ADR forms and reporting of ADRs. 99% of the respondents became aware of reporting ADRs. 96% of respondents were aware that reporting of ADRs is an integral part of pharmaceutical care. Voluntary reporting of ADRs is agreed by 90% of the respondents. Only 8% of the respondents had received reports of ADRs from the patients and only 1% of respondents had reported an ADR. Hence, educating and training the pharmacists about the program was an important element which will improve and motivate community pharmacists to participate in reporting ADRs. Conclusion: The study reveals that awareness showed a positive response in improving the knowledge about ADRs. Well trained pharmacists in the area of ADR detection, reporting and monitoring will prove to be an asset in providing better patient care. Several approaches like continuing medical education (CME), training programmes, seminars and conferences adopted by the regulatory authorities would stimulate and become mandatory to the community pharmacists to be an integral part of reporting in ADR.

Drug-drug interactions (DDIs) are common in clinical practice and are directly related to factors such as polypharmacy, aging, hepatic metabolism and decreased renal function. Individuals with chronic kidney disease (CKD) often require multiple classes of drugs being at important risk for the development of DDIs. The objectives of this study were to identify the drug-drug interactions in CKD patients admitted to medicine ward in KIMS Hospital & Research Centre, and to categorize the drug-drug interactions based on their severity. The prescriptions of 108 patients who fulfilled inclusion criteria of study were analyzed during the study period to determine drug-drug interactions (DDIs). Out of total patient included in the study, in 78 patients medical record, 388 DDIs has been found during patient`s medical record analysis. On correlating between patient`s age group and DDIs it has been found that most number of recorded DDIs, 33 patients (30.56%) were belong to age group between 51-70 years. DDIs has been classified into serious, significant and minor. Out of total 388 DDIs, 57 (14.96%), 220 (56.7%) and 111 (28.61%) were serious, significant and minor DDIs respectively. Among all prescribed drugs, diuretics were among drugs with highest number of DDIs followed by antihypertensive agents, hypoglycemia agents and antithrombotic agents respectively. In relationship between polypharmacy and DDIs the highest number of patients, 48 (44.44%) have been received 13-17 medications. Patients with renal insufficiency are at high risk of drug-drug interactions, especially in the later stages of the disease. Monitoring patient`s medication chart by clinical pharmacist to detect DDIs early can improve quality of patient health care and provide appropriate mechanism for management of drug therapy among CKD patients.

We report the results of 18 recurrent clubfeet in 13 children after Kite's method of casting treated successfully by Ponseti's technique. The average age was 8.3 months. The average preoperative Pirani's midfoot contracture score was 1.8, hindfoot contracture score was 2.4, and total score was 4.2. All patients had full correction of deformities with plantigrade feet and the scores were reduced to zero at the end of treatment. Three recurrences were found at 6 months follow-up, amounting to 17% failure rate. Two of them necessitated percutaneous tenotomy of the tendoachilles, and one underwent posteromedial soft tissue release with good result at the end of 1 year. Ponseti's method is an effective treatment option in the management of recurrent clubfeet after Kite's method. Although short-term results are promising, larger series with long-term follow-up is warranted.

We report a case of congenital pseudarthrosis of the ulna along with generalized neurofibromatosis (type I). The patient had a good clinical outcome after single-bone forearm reconstruction. In the setting of radial head dislocation following long-standing congenital pseudarthrosis of the ulna, single-bone forearm reconstruction is a viable option. It prevents the loss of hand function by the effective shortening of flexor tendons and spares movements of the humeroulnar and radiocarpal joints.