Psychosis is a mental disorder characterized by a disconnection from reality. Psychosis is a group of disorder characterized by thought disorder, abnormal behaviour, defective cognition, delusion and hallucination. Adverse drug reaction is defined as any undesired or unintended effects of drugs treatment. According to the World Health Organization (WHO)- “adverse drug reaction (ADRs) has been defined one which is noxious and unintended, and which occurs at doses normally used in man for prophylaxis, diagnosis, or therapy of disease, or modification of physiological function”. Adverse drug reactions are the most important causes of the mortality and morbidity. Antipsychotics are the most effective drugs which are used in the psychiatry in the maintenance therapy of mania, psychoses and schizophrenia. The antipsychotics drugs are chemically disparate but have the common property of alleviating the symptoms of organic as well as functional psychosis. But they also have a capacity to cause a wide range of potential adverse drug reactions that can lead to non-compliance that can impair quality of life, may cause the extra pyramidal symptoms which can lead to discontinuation of therapy and in extreme cases it may be fatal. Knowledge of assessment of ADRs due to different antipsychotics is necessary. It helps to choose to safe treatment and reduce the risk of occurrence of ADRs by the clinicians. ADR are often poorly identified and reported in day to day medical practice. As we collect more and more information about ADRs, we need an active surveillance system regarding identification and reporting of ADRs with antipsychotic drugs.  On many review articles are read & ward round participation experiences we find that antipsychotic drugs can have shown a various kind of ADRs. Psychiatrist and clinical pharmacist are need to be made aware of these potentially fatal adverse effects associated with antipsychotic drugs via conduction of patients counseling regarding (drugs, disease, doses & side effects), quality-based seminars, published medical literature, conferences, learning programs and health care camps. Keywords: Antipsychotic Drugs, WHO, Adverse Drug Reactions, Pharmacovigilance, Psychiatrist.

Objectives: The objective of study is to estimate the role of counseling on the diseased patients with asthma and its effects on the medication adherence in relation to their associated side effects on medicines on patients. Methods: The prospective case–control study was carried out at the outpatient department of respiratory department. 190 patients were enrolled for the study of 6 months. Patient counseling and follow-up were done on the basis of knowledge, attitude, and practice (KAP) questionnaire. In 190 subjects, 115 were female and 75 were male and were having the pathological history of cough cold, tuberculosis, hypertension, etc. Results: It was found that counseling causes increase in medication adherence of patients from 28.90% to 71.50% and inhaler adherence from 27.60% to 72.60%. Along with the medication adherence, fewer side effects due to various drugs were encountered such as sore throat, rhinitis, constipation, difficulty in glutition, hand tremor, and weight gain. Conclusion: The study concluded that, patient counseling plays an important role in diseases like asthma, which changes the attitude, increases the knowledge which turns out into the better medication results improving the asthmatic symptoms.

Anti-tubercular therapy induced liver injury (ATTILI) is the most important risk for the past many years. Many pre-existing factors and conditions like persisting liver injury, female gender, alcohol abuse etc. are important risk factors for the ATT induce liver injury. I read many case reports and literature review for the drugs induce liver injury, and concluded the results, ATT drugs are the most responsible for the liver injury during the therapy periods. The present case was 42-year-old male patient and known case of pulmonary tuberculosis, patients were on the ATT drugs therapy in the last 14 days. After few days of therapy, he produced signs of vomiting (multiple episode), fever (high grade), abdomen pain, coughing, loss of appetite, epigastric discomforts & generalized weakness. On general examination the patient was found to produce signs of Jaundice with yellowish appearance of the sclera. Pulmonologist had firstly withdrawal the anti-tubercular drugs therapy and started the modified anti-tubercular drugs therapy. As a Clinical pharmacist we advise the patients & patients relatives, proper monitoring of liver and renal function test should also be carried out by the health care professional specialist from time to time in order to avoid critical situations. Keywords: Anti-tubercular therapy, Anti-tubercular therapy induced liver injury, Pulmonologist, Hepatotoxicity.

Overuse disorders of tendons, or tendinopathies, present a challenge to sports physicians, surgeons, and other health care professionals dealing with athletes. The Achilles, patellar, and supraspinatus tendons are particularly vulnerable to injury and often difficult to manage successfully. Inflammation was believed central to the pathologic process, but histopathologic evidence has confirmed the failed healing response nature of these conditions. Excessive or inappropriate loading of the musculotendinous unit is believed to be central to the disease process, although the exact mechanism by which this occurs remains uncertain. Additionally, the location of the lesion (for example, the midtendon or osteotendinous junction) has become increasingly recognized as influencing both the pathologic process and subsequent management. The mechanical, vascular, neural, and other theories that seek to explain the pathologic process are explored in this article. Recent developments in the no operative management of chronic tendon disorders are reviewed, as is the rationale for surgical intervention. Recent surgical advances, including minimally invasive tendon surgery, are reviewed. Potential future management strategies, such as stem cell therapy, growth factor treatment, and gene transfer, are also discussed.

Mucormycosis is also known as “Black Fungus”. It has come into light as mucormycosis as a formidable infection in patients with severe and fatal immunosuppression. Heavy intake of steroids with no vitamin supliments and immune supplementation has led to further deterioration of health of covid-19 recovered patients. Patients are reporting back to the hospital with complains of the black fungus, UTI, recurrent diarrhoea and compromised lungs functioning. According to the doctors, cases of mucormycosis are being seen among Covid patients who were administered steroids to treat the symptoms, particularly among who are suffering from diabetes, cancer and other co-morbidities. The most prominent predisposing factors are immunosuppression followed by neutropenia and haematopoietin, stem cell transplantation, uncontrolled DM, burns, morbidity leads to increased demand of antifungal drugs. Black fungus is manifest in the air pockets located behind the forehead, nose, cheekbones and in between the eyes and teeth. Black fungus is spread to the eyes, lungs and spread even to the brain. Treatment of this fungal infection requires a multi-disciplinary approach consisting of eyes surgeons, ENT specialist, general surgeons, neurosurgeons and dental maxillofacial surgeons, among other, and the institution of the Amphotericin-B as an antifungal medicine. From COVID-19 pandemic, many reports came of the very high incidence of COVID-19 induced mucormycosis in patients with diabetes and who are on steroids during their stay in hospitals.