Background: Phenytoin is the most commonly used anti-epileptic drug (AED) in this set up due to cost effectiveness and easy availability. Significant fluctuations in serum phenytoin levels leading to toxicities or treatment failures make it an ideal candidate for therapeutic drug monitoring (TDM).Methods: Patients of age ≥18 years who were put on phenytoin were enrolled in this study. Estimation of serum phenytoin levels was done using HPLC. Data was analysed using SPSS version 20.0. Chi square test, Kruskal Wallis test were used to analyse the data.Results: A total of 105 patients enrolled in the study, twenty patients (19%) had normal or therapeutic serum phenytoin levels. Thirty-nine patients (37.2%) had sub therapeutic serum phenytoin levels, while forty-six patients (43.8%) had toxic serum phenytoin levels.Conclusions: The TDM of phenytoin should adopt a multi-disciplinary approach with active involvement of neuro-physicians, pharmacologists, pharmacists and other technical staff for improving the overall management of epilepsy. TDM data will provide the clinicians with greater insight into the factors determining the patient’s response to drug therapy.

Background: Treatment of tuberculosis involves giving multiple drugs to the patient which is done to prevent development of resistance besides targeting all bacterial sub-populations. The objective of the present study was to find out the adverse drug reactions (ADRs) of the first line anti-tubercular drugs and to calculate prevalence and causality of these drugs.Methods: The study was conducted by the Department of Pharmacology, Government Medical College, Srinagar in association with the department of Chest medicine. All patients of tuberculosis on directly observed treatment-short course (DOTS) of either sex or age group were enrolled. An assessment of the causality and allocation of ADRs was done using Naranjo’s monitoring scale and WHO-UMC scale.Results: A total of 57 ADRs with 13 different types were observed in 164 patients, with an overall prevalence of about 34.7%. Thirty seven (64.9%) ADRs were categorized as having a ‘probable’ causal relationship while 17 (29.8%) was categorized as ‘possible’ as per the Naranjo’s scale. As per the WHO-UMC monitoring scale fifty two (91.2%) were categorized as ‘possible’ while three (5.3%) were categorized as ‘certain’.Conclusions: Occurrence of ADRs generally results in non-adherance. Timely detection of ADRs through an effective pharmacovigilance programme is the need of hour. The establishment of an active pharmacovigilance centre which was set up in our institution has paved the way to improve the quality of patient care by ensuring safer use of drugs and has helped us to identify and report the various ADR’s encountered.

Background: Medical and dental students are among the frontline workers in the battle against COVID 19. As such their vaccination is mandatory. We conducted this study to assess perception and attitude of medical and dental students towards COVID-19 disease and its vaccination. Methods: A total of 185 medical and 170 dental students were included in our study. A questionnaire based on previous studies was prepared. The respondents were interviewed telephonically and appropriate responses were recorded. Results: Among 355 students enrolled in our study, higher percentage of dental students were infected with COVID-19 (26%) as against only 20% medical students. 60% dental students had been tested for COVID-19 as against 70% medical students. Majority students in both the groups had done rapid antigen test (RAT). Academic loss was the major COVID-19 disease related concern among medical students, while in dental group there were two major concerns i.e academic loss and fear of passing the infection to family. Both the groups feared anaphylaxis the most as a sequel of vaccination. The other vaccination concerns in both the groups were fever, myalgias, infertility, thrombus formation while few female students feared that vaccination may disturb their menstrual cycles. The preferred vaccine in both the groups was Covishield. Conclusion: Our study concluded that there are many hurdles in the path of vaccination even among medical and dental students. It is important to address these hesitancies especially among health care workers since their opinion and recommendation is held supreme by common masses.