ObjectivesAntiretroviral therapy (ART) medication prescribing errors in hospitalized patients still remain common. This study aimed to examine the initial prescribing of antiretroviral drug regimens for HIV clinic patients admitted to an urban academic teaching hospital. MethodsA retrospective chart review of all patients with a discharge diagnosis of HIV or AIDS was performed. Only patients actively managed by the hospital out-patient HIV clinic at the time of discharge were included in the final analysis. We compared the ART initially prescribed during hospitalization with the clinic records. Medication errors were separated by type and the prescriber's area of specialty was noted. ResultsFrom 1 January 2009 to 31 December 2009, 90 admissions in 62 patients were included in the final analysis. In 47 of those admissions, the patient had an initial regimen considered to be incorrectly prescribed; in 17 of these 47 admissions, the patient was not prescribed any ART, and in the remainder the errors were related to drug omissions, incorrect frequency/dose, and prescription of the wrong drug. The majority of admissions were by an internal medicine or non-infectious disease (ID) specialist. Average time to ART initiation was comparable among all prescribers. No statistically significant correlation was found between the number of admissions per patient or the prescriber's area of specialty and the percentage of incorrect regimens ordered. ConclusionHospital HIV medication management still remains an area of focus because of the complexity of regimens, poor medication reconciliation and limited non-HIV/ID specialist knowledge.

This study was conducted to assess efficacy of the current Indian Prevention of Mother-to-Child Transmission (PMTCT) protocol in 217 HIV-exposed infants, and to assess challenges in the early initiation of antiretroviral treatment (ART) in 18 (8.3%) infants with HIV, as determined by the HIV-1 DNA polymerase chain reaction (PCR) test at ≥ 6 weeks to <18 months of age. The mother-to-child transmission (MTCT) rate in 154 mother-baby pairs fully compliant with the PMTCT protocol was 5.2%. However, if 25 pairs who were positive using dried blood spot (DBS) DNA PCR and who did not undergo whole blood testing are included in the analysis, then the overall MTCT rate would be 19.8%. The current protocol is 50% effective considering an MTCT rate of 35-40% without any intervention. ART was initiated in 10 (55.6%) HIV-infected children at a mean ± standard deviation (SD) age of 10.45 ± 4.9 (range: 4-17.5) months; delay resulted in opportunistic infections in one-third of the children. A single-dose nevirapine PMTCT regimen should be replaced by a triple antiretroviral regimen; DBS DNA PCR-positive infants may be given ART, and simultaneously a whole blood specimen should be taken to determine whether ART should be continued.

Under National TB/HIV framework, all TB patients are referred by Revised National Tuberculosis Programme (RNTCP) service providers to Integrated Counseling and Testing Centers (ICTCs) for voluntary counseling and testing (C&T) and ICTC "TB-suspects" are referred to RNTCP facilities for TB diagnosis and treatment. HIV-TB coinfected patients are then referred to Anti Retroviral Treatment (ART) center for initiation of ART between two weeks and two months of initiating TB treatment. During the third phase of National AIDS Control Programme (NACP-III, April 2007-April 2012), 30749/130503 (23.6%) TB/HIV cross-referrals were lost to follow up (LTFU) and there was missed opportunity for 940/1884 (49.9%) HIV-TB coinfected patients for initiation of ART during TB treatment. This motivated Delhi State AIDS Control Society (DSACS) and State TB Cell (STC) to revise existing cross-referral strategy. The new strategy was launched in May 2012, wherein HIV-TB coinfected and HIV-positive "TB-suspects" were referred to nearest ART center for HIV care and investigations of TB at Chest Clinic/Designated Microscopy Centre (DMC) located within the same hospital instead of referral to area RNTCP facility. Outcome of the strategy was evaluated in March 2013. The new HIV-TB cross-referral strategy in Delhi has shown advantage over national strategy: first, improved retention of coinfected clients in HIV care; second, ensured timely initiation of TB-treatment and ART; and third, significantly improved survival of HIV-TB coinfected patients.

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BACKGROUND: The COVID-19 pandemic is escalating at an alarming rate and currently best therapy lies in prevention. OBJECTIVE:This study aims to determine knowledge ,attitude and practice of health care workers towards COVID-19.METHODOLOGY:A cross sectional descriptive study undertaken at Dedicated Covid Hospital, MBGH Udaipur,Rajasthan from April 2020 to May 2020.The response of 190 participants who filled questionnaire was tabulated and analysed .RESULT :Majority had an average knowledge (49.7%),positive attitude (57.4%) and good practice(51.1%) which was further influenced by various factors studied. CONCLUSION :Health care workers still require professional education and teachings dedicated to improve knowledge and promote good attitude and practice in regards of COVID-19.