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1
Tran, Huu Linh Phuong. "Adverse drug reactions (ADRs): Managing and Monitoring at 199 Hospital." Journal of Health Sciences 1, no. 3 (2023): 44–49. https://doi.org/10.59070/jhs010323004.
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On time detection of Adverse Drug Reactions (ADRs) helps avoid the harmful effects to patients, and promptly prevent mishaps or disasters to our health care. To assist in monitoring the safety in the use of drugs for patients, and providing maximum data to the National Center for DI&ADR on the drug safety of Phase 4 (the drugs are widely used in the community), clinical pharmacists have monitored ADRs actively instead of waiting for clinical reports. A cross-sectional description study was done by interview, review profiles, examine inpatients randomly at any time of the treatment (priority to choose patients with complex pharmacotherapy or high-risk drugs causing adverse reactions). A total of 455 interviews, examinations, and follow-ups of 15 ADRs cases were actively exploited by pharmacists (3.3%). Harmful reactions are also recorded in most specialties. The first rate was acute reaction (47%, 7 cases), the second rate was sub -acute reaction (33%, 5 cases), and the delayed reaction accounted for at least (20%, 3 cases). There are 14 drugs that are suspect or certainly related to adverse reactions, 8 of these are high-risk drugs on A-PINCH list (accounting for 57%). Proactive ADRs monitoring is necessary to minimize the risks for patients. Clinical pharmacists should get involved in the process and follow through. Aside from providing health care providers with frequent trainings to keep them with the up-to-date information needed, an improvement of prescription software to minimize ADRs should be applied.
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Shanmugam, Deepa, Sudha Mukhyaprana, Gomathi Selvakumar, Siddiraju Devipriya, and Ramachandra Chandramouliswaran. "Assessment of antitubercular treatment induced adverse drug reactions data at a tertiary care hospital." National Journal of Physiology, Pharmacy and Pharmacology 14, no. 5 (2024): 1. http://dx.doi.org/10.5455/njppp.2023.13.0945202310102023.
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Background: Standard anti-tuberculosis (TB) treatment is highly effective, but managing adverse drug responses is a major challenge that can negatively affect treatment compliance and outcomes of an anti-tubercular treatment (ATT) regimen. Hence, monitoring of these adverse drug reactions (ADRs) is very essential wherein the drug-causing ADR can be detected and an appropriate therapeutic regimen can be given to the patient. Aims and Objectives: To assess the ATT-induced ADRs in Individual Case Safety Reports (ICSRs), to find the incidence and prevalence of ADRs due to ATT, and to analyze the causality assessment of the ADRs due to ATT. Materials and Methods: A retrospective observational study was carried out using spontaneous ICSRs data from the ADR monitoring centre at Madras Medical College, Chennai. A suspected adverse drug reaction reporting form (sADR reporting form) provided by the Pharmacovigilance Programme of India was used to collect the data of an ICSR. Results: A total of 93 ICSRs were assessed during the study period. The majority of the ADRs occurred in males (n = 55), and the maximum number of ADRs were found in the age group of 18–44 years (n = 46). The majority of the ICSRs were categorized as “serious” (n = 60), of which the maximum number of ADRs belonged to the “hospitalization/prolonged hospital stay” category (n = 45). Most of the suspected ATT drugs involved in implicating ADRs were found to be fixed-dose combination pills of Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol (n = 71). Most of the ADRs were “skin and subcutaneous disorders” (n = 51) of the system organ class. The outcome of the ADRs was assessed and found that the majority of them were in the “recovering” (n = 54) category, and the majority of the ICSRs were found to be “probable” (n = 67). Conclusion: An effective implementation of a Pharmacovigilance system with early detection and management of ADRs is needed to overcome the nonadherence to TB therapy.
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Aprianti, Sartika, Prayudi Santoso, Melisa Intan Barliana, and Ivan Surya Pradipta. "ARTICLE REVIEW: THE TREATMENT PROBLEM AND ADVERSE DRUG REACTIONS IN THE TREATMENT OF MULTIDRUG-RESISTANT TUBERCULOSIS." Medical Sains : Jurnal Ilmiah Kefarmasian 8, no. 4 (2023): 1503–24. http://dx.doi.org/10.37874/ms.v8i4.988.
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Multidrug-resistant tuberculosis (MDR-TB) is the resistance of Mycobacterium tuberculosis to at least two tuberculosis (TB) drugs, rifampicin and isoniazid. The disease requires a long treatment duration with several second-line drugs. This leads to a globally low success rate of approximately 56% for MDR-TB treatment. Studies have reported that adverse drug reactions (ADRs) contribute to high rates of non-compliance, treatment discontinuation, and failure. This narrative review aimed to provide information about MDR-TB treatment modalities, various ADRs, challenges encountered in MDR-TB treatment, and instances of ADRs that can impact treatment success. This narrative review study was conducted by searching for scientific information from the primary electronic databases PubMed and Google Scholar, covering 2012-2022. Based on the literature search results, 14 studies were identified, demonstrating challenges in TB and MDR-TB treatment, along with 6 ADRs that can influence treatment success in MDR-TB patients. ADRs during MDR-TB treatment can affect patients’ physical, mental, and social well-being as well as their beliefs and behaviors related to treatment. Comprehensive support from families, communities, and healthcare providers is essential to assist patients in addressing treatment challenges and adverse ADRs. Rapid identification and strategies for monitoring and managing treatment challenges and ADRs can improve compliance and success of MDR-TB treatment. Keywords: Adverse Drug Reactions, Drug Side Effects, Multi Drug-Resistant Tuberculosis (MDR-TB), Treatment Success
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Benkhadra, Maria, Rola Ghasoub, Reem Hajeomar, et al. "Caught in the Crossfire: Unmasking the Silent Renal Threats of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia." Cancers 17, no. 1 (2024): 92. https://doi.org/10.3390/cancers17010092.
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Background: Renal adverse drug reactions (ADRs) associated with tyrosine kinase inhibitors (TKIs) in the treatment of chronic myeloid leukemia (CML) are relatively rare, and there is currently no standardized protocol for their management. Therefore, this study aimed to summarize renal ADRs related to TKIs use in CML and propose an evidence-based approach to monitor and manage these ADRs. Methods: A systematic literature review was performed to identify renal ADRs associated with TKIs in CML. Two authors screened the search results and extracted data from 37 eligible studies. These findings were then used to develop a scheme for clinicians to monitor and manage these ADRs. Results: Overall, imatinib seemed to be significantly linked to renal adverse events compared to other TKIs, and switching to dasatinib or nilotinib significantly improved renal function. Similar events were reported with bosutinib, although they were not statistically significant. However, most of the renal events reported on dasatinib were described as nephrotic syndrome that resolved with switching to imatinib. Few cases were reported with nilotinib that described tumor lysis syndrome (TLS)-related kidney injury. Conclusions: Recommendations include monitoring for progressive decline in the estimated glomerular filtration rate with imatinib, nephrotic syndrome with dasatinib, and TLS with nilotinib. Additionally, holding the offending TKI and managing renal ADRs according to local guidelines were adopted more frequently than reducing the TKI dose.
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Cui, Yuqi, Sayed Aliul Hasan Abdi, Jeanne Wei, and Gohar Azhar. "The Long-Term Cardiovascular Risks of Duloxetine Use in Older Adults: A Retrospective Medical Record-Based Adverse Drug Reaction Assessment." Journal of Clinical Medicine 13, no. 24 (2024): 7595. https://doi.org/10.3390/jcm13247595.
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Background: Duloxetine, a Serotonin–Norepinephrine Reuptake Inhibitor (SNRI), is frequently used to treat diabetic peripheral neuropathy, depression, and fibromyalgia. However, its long-term cardiovascular implications in older individuals remain underexplored, particularly in those with pre-existing cardiovascular diseases. This medical record assessment aimed to evaluate the potential cardiovascular risks of duloxetine use in older persons after prolonged use. Methods: We evaluated adverse drug reactions (ADRs) using six medical records from elderly individuals (aged 70–79) with cardiovascular comorbidities who received duloxetine (≥60 mg daily) for anxiety, depression, and chronic pain. ADRs were assessed using the Naranjo ADR Probability Scale, the Modified Hartwig and Siegel Severity Scale, and the Karch and Lasagna Algorithm. Clinical outcomes were assessed before and after duloxetine dose reduction or withdrawal. Results: All the patients had cardiovascular-related ADRs, such as peripheral cyanosis, vasoconstriction, atrial fibrillation, and hypertensive episodes. Five of the six patients experienced mild cognitive impairment [Montreal Cognitive Assessment (MoCA) scores of 11–24/30]. A positive dechallenge (symptom resolution) was observed in all medical records after decreasing or discontinuing duloxetine. It is interesting to note that four medical records demonstrated significant improvement in cyanosis, blood pressure, and anxiety after decreasing or discontinuing duloxetine use. There was no rechallenge in this study. The causality was considered probable (Naranjo Scale), and ADRs were categorized as moderately severe (Hartwig and Siegel Scale) in all the medical records. However, with adequate monitoring, the ADRs were considered preventable (Schumock and Thornton Scale). Conclusions: Long-term duloxetine use could cause significant cardiovascular problems in older individuals, particularly those who already have cardiovascular difficulties. Regular monitoring of cardiovascular function and early steps such as dose adjustment or drug withdrawal of duloxetine may reduce the prognosis of ADRs. More studies are required to create safer treatment strategies for managing depression and anxiety in older people with cardiovascular issues.
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Shivani, Manvar Sonal Kumbhar Dr. Nilesh Chougule. "Pharmacovigilance of Antimicrobial Drug: Azithromycin." International Journal of Pharmaceutical Sciences 2, no. 12 (2024): 1450–70. https://doi.org/10.5281/zenodo.14396131.
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Pharmacovigilance of antimicrobial drugs is critical for ensuring their safety and efficacy in clinical use. Azithromycin, a widely used macrolide antibiotic, is commonly prescribed for a variety of bacterial illnesses, such as respiratory and sexually transmitted diseases. Despite its general safety profile, concerns regarding adverse drug reactions (ADRs), resistance, and interactions with other drugs necessitate continuous monitoring. This review explores the pharmacovigilance data associated with Azithromycin, highlighting common and rare ADRs, such as gastrointestinal disturbances, cardiovascular effects, and potential risks in vulnerable populations. Moreover, the role of pharmacovigilance systems in detecting and managing these effects is emphasized, alongside the importance of post-marketing surveillance to assess long-term safety. Effective pharmacovigilance can guide healthcare professionals in optimizing treatment protocols and minimizing the risks of Azithromycin use, ensuring better patient outcomes and public health.
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T, Reema, Anuradha M, Ancy George, and Sruthi N. "The pattern of adverse effects related to antimicrobial therapy in a tertiary care hospital." National Journal of Physiology, Pharmacy and Pharmacology 12, no. 7 (2022): 1. http://dx.doi.org/10.5455/njppp.2022.12.05241202203062022.
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Background: Antimicrobial drugs are life-saving drugs but they come with their own share of adverse drug reactions (ADRs). Institutional drug policy helps in the rational use of the antimicrobial for the given clinical condition. This helps in controlling the development of resistance as well as minimizing adverse events. Aims and Objectives: This study aims to share the pattern of adverse reactions seen to the commonly prescribed antimicrobials. Materials and Methods: This is a retrospective, observational study. The data of patients, admitted to a tertiary care center in North Kerala who reported adverse effects related to antimicrobial treatment, were obtained from the case files from the medical record library. ADRs with antimicrobials reported during the period from November 2018 to November 2019 were obtained and the data were expressed as percentages in Microsoft excel. Causality assessment was done using the world health organization casualty scale. Results: 92 case reports were analyzed. Among the different antimicrobials used, Ciprofloxacin was the most commonly prescribed antimicrobial (18.5%) followed by ceftriaxone (12%). 13 different patterns of ADRs were obtained following the use of these drugs, among which allergic reactions to drugs were the most common (71.7%) with a causality assessment showing it to be the probable cause. Conclusion: The monitoring of ADRs to antimicrobials is the need of the hour. This study helped in determining the different patterns of ADRs with antimicrobials. Active surveillance and complete reporting help in identifying these and reporting and managing them to prevent such occurrences in the future.
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Femi, Retna. J., Amudhan Arvind E., and R. Komala. "Adverse Drug Reactions to Anti Retro Viral Therapy in a Tertiary Care Teaching Hospital." International Journal of Pharmaceutical and Clinical Research 15, no. 2 (2023): 969–74. https://doi.org/10.5281/zenodo.12822821.
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<strong>Introduction: </strong>Acquired immune deficiency syndrome (AIDS) is a persistent and possibly lethal illness of the immune system caused by the Human immunodeficiency virus (HIV). Highly active antiretroviral therapy (HAART), a blend of minimum 3 medications which had helped very much in reducing morbidity and mortality to a significant extent. All drugs used in treatment of HIV has many side effects related to it and is one of the main causes for altering or stopping drug management also irregular intake of drugs leads to poor compliance. Hence proper assessment of ADRs may help treating doctors to alter the medicament for managing HIV infection. Hence objective of our study is to estimate risk factors causing adverse drug reaction in relation to ART among HIV patients, and also to evaluate the causality and Severity of ADRs. <strong>Material and Methodology: </strong>This research work was done as an observational study by pharmacology department along with ART center in a tertiary care hospital. In our study 200 patients were included who were started with HAART and were for a period of next one year they were followed. Causality assessment of ADRs was done by Naranjo scale and Severity assessment of ADRs by Hartwig and Seigel’s severity scale. <strong>Results: </strong>In our study out of the 200 patients 75 (37.5%) had experienced ADRs. System wise most of ADRs were connected to Hematological (32%), GIT (27%) and CNS (23%). The majority of the ADRs were with ZLN regimen (74%). Naranjo causality evaluation revealed 62 % were possible, 31 % were probable and 7% were definitive ADRs. Also 49% were mild and 51% were moderately severe in intensity based on Hartwig & Seigels scale. <strong>Conclusions: </strong>Adverse drug reaction among PLHA on management with ART regimen is an important health issue compliance to treatment. So, constant monitoring is necessary to thwart life-threatening ADR and to improve treatment outcome.
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Kiranmai, Venkatagiri1 Bhavya Sai Sakhamuri2 Mitta Putta Pooja*3 Sandeep Reddy Ambati4 Sai Keshava Reddy A.5. "Doxycycline induced Urticaria: A Case Report." International Journal of Pharmaceutical Sciences 3, no. 3 (2025): 739–44. https://doi.org/10.5281/zenodo.14998605.
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Doxycycline, a second-generation bacteriostatic antibiotic, is widely used to treat a variety of infections, including those caused by intracellular pathogens. It is effective against both gram-positive and gram-negative bacteria and has potential therapeutic benefits for conditions such as cancer and Alzheimer's disease. However, its use is contraindicated in children below eight years due to possible adverse effects. This case report presents a 28-year-old female patient who developed drug-induced urticaria after being treated with doxycycline for suspected Chikungunya viral arthritis. Following a detailed clinical assessment and laboratory investigations, the patient exhibited symptoms consistent with drug-induced urticaria, including angioedema and severe itching. Management involved the withdrawal of doxycycline, administration of systemic corticosteroids, antihistamines, and supportive care. The patient demonstrated significant improvement, highlighting the importance of recognizing and promptly managing adverse drug reactions (ADRs). This case emphasizes the necessity for on-going monitoring of drug safety and the need for clinical awareness regarding rare but serious ADRs associated with commonly used medications like doxycycline.
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Kaj, Kanhai Hiren. "Assessing the knowledge and practice of the Irish Community Pharmacists in reporting Adverse Drug Reactions and Falsified Medicines." International Journal of Drug Regulatory Affairs 11, no. 3 (2023): 1–10. http://dx.doi.org/10.22270/ijdra.v11i3.603.
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Background: Pharmacovigilance is a critical aspect of healthcare, enabling the monitoring of adverse drug reactions (ADRs), eradication of falsified medicines (FMs), identification of medication errors, monitoring off-license drug use, addressing abuse and misuse, assessing lack of efficacy, tracking poisoning incidents, managing drug-drug/food interactions, ensuring the destruction of expired stock, and evaluating drug-related mortality. It is essential for healthcare professionals to be aware of their role in Pharmacovigilance.
 Objective: This study aims to assess the current knowledge and reporting practices of ADRs and FMs among community pharmacists in Ireland, focusing on two important components of Pharmacovigilance.
 Method: The research employed a cross-sectional, observational design, utilizing an online questionnaire survey to gain insights into the pharmacists' knowledge and practices related to Pharmacovigilance programs, ADR reporting, FMs, and their opinions on their role in these areas.
 Results: The study found that Irish colleges and universities played a significant role in providing Pharmacovigilance education to pharmacy students. The majority of pharmacists demonstrated a good understanding of Pharmacovigilance, but only a third of them were aware of Irish legislation in this regard. Additionally, only 20.23% of pharmacists believed that Irish patients were aware of ADR reporting, although 92.49% were familiar with the Health Products Regulatory Authority's (HPRA) ADR reporting system. The findings suggest the need for pharmacists to educate their patients about ADR reporting, while recognizing the convenience of the HPRA reporting system.
 Conclusion: Overall, the study revealed that most community pharmacists possess a solid understanding of the fundamental aspects of Pharmacovigilance, including ADRs and FMs. However, there are areas for improvement, such as raising awareness among patients about ADR reporting. The findings highlight the importance of continuous education and communication to enhance Pharmacovigilance practices among community pharmacists in Ireland.
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Kusuma, Kumari.S* Rajesh .G Dr. Siddarama. R. "DRUG INDUCED DYSELECTROLYTEMIA –A CASE REPORT." Indo American Journal of Pharmaceutical Sciences 04, no. 07 (2017): 2047–50. https://doi.org/10.5281/zenodo.834968.
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Abstract: Spiranolactone and Eplerenone were belongs to the class of potassium sparing diuretics where as Torsemide belongs to the loop diuretic class, they mainly acts by blocking the function of aldosterone hormone to retain the sodium and excrete potassium. By irrational use of these drugs induced dyselectrolytemia like hyperkalemia and hyponatremia. A 55 years female patient was admitted in cardiology department with the chief complaints of drowsiness and slow response to commands by using of the diuretics (Spiranolactone , Eplerenone and Torsemide) causes the electrolytes induced hyperkalemia and hyponatremia. These electrolytes abnormalities will causes the cardiac arrhythmias , muscle paralysis and sometimes death also. Whereas both rechallenge and dechallenge was done and the ADR assessment scales like Naranjo and WHO gives certain ADR and it can be managed by stopping of the above drugs. So, clinical pharmacist plays a major role in detecting, monitoring and managing of ADRs.
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M, Srija. "Advancing Pharmacovigilance: Safeguarding Drug Safety and Enhancing Public Health." Advances in Pharmacology & Clinical Trials 9, no. 3 (2024): 1–8. http://dx.doi.org/10.23880/apct-16000241.
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Pharmacovigilance is integral to ensuring the safety and efficacy of pharmaceutical products throughout their lifecycle. This review explores the essential components of pharmacovigilance, highlighting its role in monitoring adverse drug reactions (ADRs), detecting safety signals, and managing risks associated with medications. Key components include adverse event reporting systems, advanced signal detection methodologies utilizing artificial intelligence and real-world data, rigorous data management and evaluation processes, and compliance with regulatory requirements. Effective communication strategies ensure dissemination of safety information to healthcare professionals and the public, promoting informed decisionmaking and enhancing patient safety. Challenges such as data quality, regulatory adaptation, and global harmonization are discussed, alongside future directions aimed at improving pharmacovigilance practices. By continuously evolving to integrate technological advancements and global collaboration, pharmacovigilance contributes significantly to public health by maintaining the integrity and safety of pharmaceutical therapies worldwide.
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NA, Priyanshi. "Pharmacovigilance and Risk Management: A Study on AI-Based Drug Safety Monitoring." International Journal for Research in Management & Pharmacy 14, no. 2 (2025): 10–17. https://doi.org/10.63345/ijrmp.v14.i2.2.
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Pharmacovigilance has evolved significantly in recent decades, yet challenges remain in monitoring drug safety and managing risk in a timely manner. With the rapid advancement of artificial intelligence (AI) techniques, novel approaches to drug safety monitoring are emerging that promise to improve signal detection, risk evaluation, and post‐market surveillance. This study investigates the application of AI-based methods in pharmacovigilance, with a specific focus on risk management strategies to enhance patient safety. We review the state-of-the-art literature up to 2017, identify key methodological developments, and propose a simulation-based framework that integrates machine learning algorithms for signal detection with risk assessment models. Through statistical analysis, including a comparative table of performance metrics, our simulation research demonstrates that AI-based systems can offer increased sensitivity and specificity over traditional methods. The results indicate that such systems can provide early warnings of adverse drug reactions (ADRs), enabling regulatory bodies and healthcare providers to implement timely interventions. Our findings suggest that the integration of AI in pharmacovigilance is not only feasible but also highly promising in the context of risk management, although challenges related to data quality, algorithm transparency, and ethical considerations remain. The paper concludes with recommendations for future research and strategies for integrating AI into existing pharmacovigilance infrastructures.
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Hajeomar, Reem, Maria Benkhadra, Rola Ghasoub, et al. "Renal Adverse Events in Chronic Myeloid Leukemia: Can the Exposure to One TKI be the Culprit?" Blood 144, Supplement 1 (2024): 7920. https://doi.org/10.1182/blood-2024-206775.
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Introduction Tyrosine kinase inhibitors (TKIs) have revolutionized prognosis and survival of chronic myeloid leukemia (CML). This expanding use of TKIs has raised concerns regarding the management of their associated toxicities, particularly nephrotoxicity, for which the optimal measures are yet to be determined, given the lack of established guidelines. This systematic review aimed to provide guidance for this population by summarizing the literature on the effects of renal impairment on TKI therapy and the renal adverse reactions (ADRs) associated with the use of one or more TKIs in CML. Herein, the preliminary findings on the renal ADRs associated with the exposure to only one TKI in CML patients are described. Methods A comprehensive literature review was conducted using PubMed and EMBASE, limited to human studies published in English until April 2024. The utilized search terms focused on FDA-approved TKIs and renal impairment in CML patients. All publication types were allowed except for book chapters, reviews, and those reporting TKI use in non-CML cases. Data collected included the study details, type of TKI, population characteristics, and renal ADRs. Results A total of 37 studies met the inclusion criteria. Of these studies, 15 explicitly reported the use of a single TKI and are reported here (7 case reports/series, 6 observational cohort studies, 1 meta-analysis of FDA Adverse Events Reporting System (FAERS) reports, and 1 post-marketing surveillance study). The full-text article will report the results of the remaining studies (pharmacokinetics of TKIs in renal impairment and the renal ADRs reported with the use of two or more TKIs). Overall, imatinib was the most commonly reported TKI to have incidence of renal ADRs (n=11) when compared to dasatinib (n=2) or nilotinib (n=2). Findings suggested that long-term imatinib use is significantly associated with a progressive, albeit likely reversible, decline in the estimated glomerular filtration rate (eGFR) as described by Celestino (2023), Singh (2023), Moura (2019), Sakurai (2016), and Rüžičková (2015). New-onset chronic kidney disease (CKD) as well as deterioration of pre-existing kidney dysfunction, were also frequently reported with imatinib use. Three cases reported imatinib-induced progression of baseline CKD, leading to dialysis initiation (Nakahara, 2021) and subsequent mortality in 2 of the 3 cases (Mestroni, 2011) and (Kitiyakara, 2002). Nakahara (2021); however, reported successful rechallenging with imatinib during dialysis with the use of therapeutic drug monitoring (TDM). Moreover, the imatinib-induced decline in eGFR was significantly correlated with a reduction in hemoglobin levels over time (Singh, 2023) and (Sakurai, 2016). Teuma (2016) also reported renal vein thrombosis and subsequent nephrotic syndrome during imatinib therapy. Conversely, no significant renal deterioration was observed in a CKD patient who underwent a second kidney transplant while on imatinib (Thiem, 2021). Post-marketing renal ADRs with nilotinib were rare (Ahn, 2022), and were described to be secondary to tumor lysis syndrome (TLS) in a case series (Hua, 2013), thereby emphasizing the need for appropriate TLS prevention and dose titration upon treatment initiation. Dasatinib was associated with a markedly higher incidence of nephrotic syndrome compared to other TKIs in the FAERS analysis (Calizo, 2019). A case report also described dasatinib-induced glomerulosclerosis and secondary nephrotic syndrome (Loi, 2018). In general, potential risk factors for developing renal events include older age, baseline hypertension and diabetes, TLS, and concomitant nephrotoxic medications. Interventions for managing renal ADRs encompassed the temporary or permanent discontinuation of TKI, hydration, diuresis, corticosteroids (nephrotic syndrome), initiation of dialysis, and TDM (imatinib). Conclusion In conclusion, TKIs remain the cornerstone of CML treatment; however, the monitoring for renal ADRs is crucial. In particular, the progressive decline in eGFR with imatinib, nephrotic syndrome with dasatinib and TLS with nilotinib should be monitored. Furthermore, evidence surrounding the incidence of renal ADRs with following the exposure to multiple TKIs is under analysis. This will provide evidence-based guidance for clinicians to optimize the use of TKIs in patients with CML, while minimizing the risk of nephrotoxicity.
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Yu, Caili, Haiyang Tong, Daoyi Huang, et al. "Model for Inverting the Leaf Area Index of Green Plums by Integrating IoT Environmental Monitoring Data and Leaf Relative Content of Chlorophyll Values." Agriculture 14, no. 11 (2024): 2076. http://dx.doi.org/10.3390/agriculture14112076.
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The quantitative inversion of the leaf area index (LAI) of green plum trees is crucial for orchard field management and yield prediction. The data on the relative content of chlorophyll (SPAD) in leaves and environmental data from orchards show a significant correlation with LAI. Effectively integrating these two data types for LAI inversion is important to explore. This study proposes a multi−source decision fusion LAI inversion model for green plums based on their adjusted determination coefficient (MDF−ADRS). First, three statistical methods—Pearson, Spearman rank, and Kendall rank correlation analyses—were used to measure the linear relationships between variables, and the six environmental factors most highly correlated with LAI were selected from the orchard’s environmental data. Then, using multivariate statistical analysis methods, LAI inversion models based on environmental feature factors (EFs−PM) and SPAD (SPAD−PM) were established. Finally, a weight optimization allocation strategy was employed to achieve a multi−source decision fusion LAI inversion model for green plums. This strategy adaptively allocates weights based on the predictive performance of each data source. Unlike traditional models that rely on fixed weights or a single data source, this approach allows the model to increase the influence of a key data source when its predictive strength is high and reduce noise interference when it is weaker. This dynamic adjustment not only enhances the model’s robustness under varying environmental conditions but also effectively mitigates potential biases when a particular data source becomes temporarily unreliable. Our experimental results show that the MDF−ADRS model achieves an R2 of 0.88 and an RMSE of 0.39 in the validation set, outperforming other fusion methods. Compared to the EFs−PM and SPAD−PM models, the R2 increased by 0.19 and 0.26, respectively, and the RMSE decreased by 0.16 and 0.22. This model effectively integrates multiple sources of data from green plum orchards, enabling rapid inversion and improving the accuracy of green plum LAI estimation, providing a technical reference for monitoring the growth and managing the production of green plums.
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Ahmed, Rashed. "Ensuring Quality Medicine: A Comprehensive Overview of EMA and DGDA's History, Structure, and Functions." RADINKA JOURNAL OF HEALTH SCIENCE 2, no. 2 (2024): 254–66. https://doi.org/10.56778/rjhs.v2i2.362.
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The study highlights the origins of drug regulation, tracing back to the early 19th century in the United States with the establishment of the Food and Drug Administration (FDA), and discusses the evolution and significance of drug regulatory bodies worldwide. The EMA and DGDA are scrutinized for their efforts in maintaining high standards for drug approval, monitoring clinical trials, and managing post-marketing surveillance to prevent adverse drug reactions (ADRs). The EMA’s role in coordinating with EU member states on pharmacovigilance and the DGDA’s initiatives in Bangladesh, including the implementation of a nationwide drug database and pharmacovigilance system, are explored in detail. The article concludes by emphasizing the essential role of these regulatory bodies in safeguarding public health through stringent regulation and continuous monitoring of pharmaceuticals, thereby ensuring that only safe and effective medicines are available to consumers . It also provides an in-depth analysis of the roles, structures, and historical contexts of the European Medicines Agency (EMA) and the Directorate General of Drug Administration (DGDA). It outlines how these regulatory bodies ensure the safety, efficacy, and quality of medicinal products. The EMA, serving the European Union, and the DGDA, operating in Bangladesh, play critical roles in drug approval processes, pharmacovigilance, and maintaining public health standards. By setting rigorous guidelines and monitoring compliance, these agencies help safeguard the health of millions, ensuring that only safe and effective medications are available in the market. The paper underscores the importance of these regulatory bodies in promoting public health and supporting the pharmaceutical industry's development and innovation.
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Xia, Xudong, Xue Yang, Jiayi Du, et al. "Exploring willingness to use adverse drug reaction reporting systems: a multicentre qualitative study in China based on the technology acceptance model and task-technology fit integration approach." BMJ Open 14, no. 10 (2024): e087701. http://dx.doi.org/10.1136/bmjopen-2024-087701.
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BackgroundAdverse drug reaction (ADR) reporting systems are critical for monitoring and managing drug safety. However, various factors influence the willingness to use these systems. This study aimed to investigate the willingness to use ADR reporting systems through an integrated model of the Technology Acceptance Model (TAM) and Task-Technology Fit (TTF) theory, conducting a multicentre qualitative study from the user’s perspective.MethodsThis study used qualitative research methods, including in-depth interviews with clinicians, nurses, pharmacists and administrators who reported ADRs through the National Adverse Drug Reaction Monitoring System (NADRMS) and the China Hospital Pharmacovigilance System (CHPS). The interviews were audio-recorded, transcribed verbatim and analysed using QDA Miner software for data management and thematic analysis.ResultsEighteen healthcare workers from five healthcare organisations participated in the study. They found the ease of use and usefulness of the current NADRMS and CHPS to be acceptable. The essential technical requirements identified included accuracy, standardisation, timeliness and confidentiality. However, challenges such as inaccurate information capture, unstable interfacing with medical record systems, low reporting efficiency and lack of data sharing were highlighted. Overall, front-line healthcare workers exhibited a generally negative attitude towards using NADRMS and CHPS, driven more by necessity than preference. Factors influencing their willingness to use these systems included ease of use, practicality, risk perception and social impact, with varying attitudes and requirements observed between user groups.ConclusionThis study provides practical recommendations that can be readily implemented to enhance the effectiveness and sustainability of ADR reporting systems. While front-line users in China acknowledged the systems’ ease of use and usefulness, they also noted significant gaps in technological adaptation. They expressed the need for improvements in data openness and sharing, accessibility and system intelligence.
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Sun, Hongxia. "A Logistics Monitoring Technology Based on Wireless Sensors." International Journal of Online Engineering (iJOE) 13, no. 07 (2017): 150. http://dx.doi.org/10.3991/ijoe.v13i07.7375.
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<p><span style="font-size: small;"><span style="font-family: Times New Roman;">A logistics monitoring technology is proposed based on the analysis for the traditional logistics enterprises. By tracking the existing monitoring system and data transmission technology, a new technology WSN-based logistics vehicle monitoring system is adopted. The practical significance to monitoring and managing the logistics processes effectively is to diminish transportation costs, improve logistics efficiency and avoid needless economic loss. The results show that the WSN not only realizes the positioning of the vehicle, but also can effectively manage the goods, improve the efficiency in the transportation management of the goods. In addition, this experiment system also adds a temperature sensitive alarm circuit to improve the safety performance of the terminal. Based on the result, it is concluded that this technology can adjust the transmission power and reduce energy consumption to extend the network life cycle as long as possible.</span></span></p>
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Yanti, Nafri, Yudi Setiawan, and Dyah Setyo Rini. "PELATIHAN MENGELOLA DAFTAR PUSTAKA MENGGUNAKAN APLIKASI MENDELEY PADA MUSYAWARAH GURU MATA PELAJARAN (MGMP) BAHASA INDONESIA SMA/SMK KOTA BENGKULU." Jurnal Berdaya Mandiri 2, no. 1 (2020): 268–84. http://dx.doi.org/10.31316/jbm.v2i1.432.
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The Mendeley application training at the MGMP Bahasa Indonesia SMA/SMK in Bengkulu City aims to improve the knowledge and skills of the teacher using the Mendeley application, as well as facilitate management and library writing. This activity is carried out using several methods, namely observation/monitoring, interviews, and questionnaires. The results of this training activity can be used as one of the learning media for the preparation of bibliography, so this activity is not only useful for teachers, but also students taught by teachers in their respective work units. In addition, this activity can increase the ability of teachers to write scientific articles, especially in compiling and managing bibliography. Based on the data, this training adds to the insights of teachers in managing libraries and is able to apply this application in teaching and learning in their respective schools.
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Chrison Tom Joseph and Vinaykumar S. Appannavar. "Pediatrics in Space: Costs, medical care, and health management for children beyond earth." World Journal of Advanced Research and Reviews 26, no. 1 (2025): 3927–30. https://doi.org/10.30574/wjarr.2025.26.1.3140.
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As humanity prepares for extended space missions and settlement on other planets, the challenges of pediatric health and well-being demand special attention. Managing the costs of living, healthcare, and specialty care for children in space environments adds complexity to already demanding missions. This paper explores the financial, logistical, and health-related aspects of pediatric care in space, comparing these with Earth-based systems. It also offers strategies for mitigating health risks unique to children in space, including medical screenings, specialized healthcare infrastructure, and developmental monitoring. Drawing insights from space economics, pediatric medicine, and healthcare policy, this paper provides recommendations for sustainable pediatric care frameworks in extraterrestrial environments.
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Xiao, Zhiyuan, Yu Hou, and Haorui Li. "Perceptions of Digital Monitoring Technology for Activities of Daily Living (ADLs): A Semi-Structured Interview Study of Older Adults and Informal Caregivers." Journal of Electronic Research and Application 9, no. 3 (2025): 178–92. https://doi.org/10.26689/jera.v9i3.10804.
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With China’s rapidly aging population and the growing preference for aging in place, digital monitoring technologies have emerged as potential tools to support older adults in managing their activities of daily living (ADLs). This study explores the perceptions and acceptance of these technologies among elderly individuals living alone and their informal caregivers (ICs) in Nanshan District, Shenzhen. Grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT), the study employed semi-structured and photo-elicitation interviews to analyze how performance expectancy, effort expectancy, social influence, and facilitating conditions shape technology adoption. The findings reveal clear intergenerational differences: caregivers show higher acceptance and a better understanding of the benefits and functionalities of wearable and environmental monitoring devices, while older adults often express skepticism due to concerns over privacy, usability, and cost. Many elderly participants also cite discomfort, technical complexity, and lack of training as barriers to adoption. Despite these obstacles, both groups acknowledge the potential safety and health benefits of such technologies. The study highlights the need for privacy-by-design features, customized user interfaces, and enhanced digital literacy programs tailored to both elderly users and their caregivers. The research contributes to a sociotechnical understanding of aging-in-place technologies in China and provides actionable insights for developers, policymakers, and healthcare practitioners aiming to enhance home-based elder care.
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Patil, Aishwarya Ashok, and Spriha Deshpande. "AI-Enhanced Fleet Management and Predictive Maintenance for Autonomous Vehicles." International journal of data science and machine learning 5, no. 1 (2025): 229–49. https://doi.org/10.55640/ijdsml-05-01-21.
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Managing a fleet of autonomous vehicles (AVs) efficiently is crucial for keeping them running smoothly and safely. In this paper, we present a Fleet Management System (FMS) that uses data analytics and AI to help fleet managers monitor vehicle performance, predict maintenance needs, and optimize operations. The system continuously collects data from various vehicle sensors and processes it to detect issues like low fuel, battery health, or ADAS faults. It also makes safety recommendations, predicts when vehicles need maintenance, and helps decide the best routes for each vehicle. By combining real-time monitoring with AI-driven decision-making, this system improves safety, reduces downtime, and enhances overall fleet efficiency. We explore how this AI-based approach can transform fleet management and provide a solid foundation for future advancements in autonomous vehicle operations.
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Acierno, M., and D. Fiorani. "INNOVATIVE TOOLS FOR MANAGING HISTORICAL BUILDINGS: THE USE OF GEOGRAPHIC INFORMATION SYSTEM AND ONTOLOGIES FOR HISTORICAL CENTERS." ISPRS - International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences XLII-2/W11 (May 4, 2019): 21–27. http://dx.doi.org/10.5194/isprs-archives-xlii-2-w11-21-2019.
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<p><strong>Abstract.</strong> A recent study and the digitalization of historical centres have developed a completely new strategy for the conservation management of urban buildings through the ‘Risk Map’ of MiBAC. Issues, aims and structure of the Territory Information System (TIS) have been wholly outlined in a dedicated book that describes the structure of the system, also following a historical framing of the debate and the previous experiences. The elaboration of a dedicated ontology adds the opportunity to make the same data available to other kind of software, beginning from HBIM Systems. This aim is pursued developing a special extension of CIDOC-CRM, an already consolidated ontology initially dedicated to the conservation issue of museums. The work has firstly considered the field of architectural conservation and recently further developed addressing historical centres. In this way, a synthetic description of the buildings, including the main features together with vulnerability and transformation index, will allow, through the 3D representation of the town, a stable monitoring of the urban tissue, constantly up to date with the new data deriving from the interventions gradually realized.</p>
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Gajbhiye, Bipin, Om Goel, and Pandi Kirupa Gopalakrishna Pandian. "Managing Vulnerabilities in Containerized and Kubernetes Environments." Journal of Quantum Science and Technology 1, no. 2 (2024): 59–71. http://dx.doi.org/10.36676/jqst.v1.i2.16.
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The rise of containerized environments, exemplified by Docker and Kubernetes, has revolutionized software deployment and orchestration, enabling agile development and efficient resource utilization. However, the adoption of these technologies also introduces unique security challenges that organizations must address to safeguard their applications and infrastructure. This paper explores the complexities of managing vulnerabilities in containerized and Kubernetes environments, offering a comprehensive analysis of the potential risks and strategies to mitigate them.Containers encapsulate applications with their dependencies, ensuring consistency across different environments. However, this encapsulation can mask underlying vulnerabilities in the application code, base images, or third-party libraries. The ephemeral nature of containers, designed to be short-lived and scalable, adds another layer of complexity, as vulnerabilities can propagate rapidly across environments if not detected and addressed promptly. Moreover, the shared nature of the underlying host operating system and kernel in containerized environments increases the attack surface, making it crucial to secure both the containers and the host.Kubernetes, as a powerful orchestration platform, introduces additional layers of complexity in vulnerability management. The dynamic nature of Kubernetes clusters, with their multiple components such as pods, services, and nodes, can lead to misconfigurations, inadequate access controls, and exposure to security threats. Misconfigurations, such as overly permissive network policies or improper role-based access controls (RBAC), can lead to unauthorized access, privilege escalation, and data breaches. Additionally, the integration of third-party plugins and extensions into Kubernetes clusters can introduce new vulnerabilities, making it imperative to monitor and manage these components effectively.This paper delves into several key aspects of vulnerability management in containerized and Kubernetes environments. Firstly, it examines the importance of securing container images by employing best practices such as using minimal base images, regularly updating images, and scanning them for known vulnerabilities. The paper highlights the role of image scanning tools that can detect vulnerabilities in both base images and application code, emphasizing the need for continuous scanning throughout the development lifecycle.Secondly, the paper discusses the significance of runtime security in containerized environments. While securing container images is critical, monitoring and protecting containers during runtime is equally important. The paper explores tools and techniques for runtime security, including anomaly detection, behavior analysis, and intrusion detection systems that can identify and respond to threats in real-time.Furthermore, the paper addresses the challenges of managing vulnerabilities in Kubernetes clusters. It underscores the importance of securing the Kubernetes control plane, which includes securing API servers, etcd databases, and implementing stringent RBAC policies. The paper also explores the role of network security in Kubernetes, advocating for the use of network policies to control traffic flow between pods and ensure that only authorized communication is allowed.In addition to technical measures, the paper emphasizes the need for organizational practices to manage vulnerabilities effectively. This includes fostering a security-first culture, conducting regular security audits, and ensuring that development and operations teams are aligned on security best practices. The paper also highlights the importance of incident response planning and the need for rapid patching and updates to address newly discovered vulnerabilities.In conclusion, managing vulnerabilities in containerized and Kubernetes environments requires a multifaceted approach that combines technical measures with organizational practices. As organizations increasingly rely on these technologies for their application deployment and orchestration, a proactive and holistic approach to security is essential to mitigate risks and protect critical assets. This paper provides a roadmap for organizations to enhance their vulnerability management strategies, ensuring that their containerized and Kubernetes environments are secure, resilient, and capable of withstanding evolving threats.
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Özdemir, Kamer, and Ahu Kömeç Mutlu. "Cost-Effective Data Acquisition Systems for Advanced Structural Health Monitoring." Sensors 24, no. 13 (2024): 4269. http://dx.doi.org/10.3390/s24134269.
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With the growing demand for infrastructure and transportation facilities, the need for advanced structural health monitoring (SHM) systems is critical. This study introduces two innovative, cost-effective, standalone, and open-source data acquisition devices designed to enhance SHM through the latest sensing technologies. The first device, termed CEDAS_acc, integrates the ADXL355 MEMS accelerometer with a RaspberryPi mini-computer, ideal for measuring strong ground motions and assessing structural modal properties during forced vibration tests and structural monitoring of mid-rise buildings. The second device, CEDAS_geo, incorporates the SM24 geophone sensor with a Raspberry Pi, designed for weak ground motion measurements, making it suitable for seismograph networks, seismological research, and early warning systems. Both devices function as acceleration/velocity Data Acquisition Systems (DAS) and standalone data loggers, featuring hardware components such as a single-board mini-computer, sensors, Analog-to-Digital Converters (ADCs), and micro-SD cards housed in protective casings. The CEDAS_acc includes a triaxial MEMS accelerometer with three ADCs, while the CEDAS_geo uses horizontal and vertical geophone elements with an ADC board. To validate these devices, rigorous tests were conducted. Offset Test, conducted by placing the sensor on a leveled flat surface in six orientations, demonstrating the accelerometer’s ability to provide accurate measurements using gravity as a reference; Frequency Response Test, performed at the Gebze Technical University Earthquake and Structure Laboratory (GTU-ESL), comparing the devices’ responses to the GURALP-5TDE reference sensor, with CEDAS_acc evaluated on a shaking table and CEDAS_geo’s performance assessed using ambient vibration records; and Noise Test, executed in a low-noise rural area to determine the intrinsic noise of CEDAS_geo, showing its capability to capture vibrations lower than ambient noise levels. Further field tests were conducted on a 10-story reinforced concrete building in Gaziantep, Turkey, instrumented with 8 CEDAS_acc and 1 CEDAS_geo devices. The building’s response to a magnitude 3.2 earthquake and ambient vibrations was analyzed, comparing results to the GURALP-5TDE reference sensors and demonstrating the devices’ accuracy in capturing peak accelerations and modal frequencies with minimal deviations. The study also introduced the Record Analyzer (RECANA) web application for managing data analysis on CEDAS devices, supporting various data formats, and providing tools for filtering, calibrating, and exporting data. This comprehensive study presents valuable, practical solutions for SHM, enhancing accessibility, reliability, and efficiency in structural and seismic monitoring applications and offering robust alternatives to traditional, costlier systems.
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Aoun, Dani. "Assessing the economic sustainability of managing protected areas using the CVM and CBA approaches." Management of Environmental Quality: An International Journal 27, no. 4 (2016): 374–89. http://dx.doi.org/10.1108/meq-04-2015-0069.
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Purpose – The purpose of this paper is to design a preservation policy aimed at safeguarding the Ehden Natural Reserve, a reserve providing shelter to a substantial number of endangered species. Design/methodology/approach – The current paper, offers an approach which merges contingent valuation and cost-benefit analysis (CBA) to design a preservation policy aimed at safeguarding the reserve. Contingent valuation is used to estimate the expected benefits from the reserve for both local residents and tourists visiting Ehden, while using a certainty analysis approach to explore the problem of hypothetical bias. A CBA is then applied to the findings to evaluate a ten year plan to preserve the protected area through a non-profit foundation. Findings – Findings from the analysis support the feasibility of a project of this nature, which shows a positive NPV within the studied period and at an acceptable social discount rate (SDR). The balance between benefit and cost is thus always positive, except in some pessimistic cases when analyzing the sensitivity of the model’s critical variables, particularly the number of visitors, the different WTPs for visitors and locals and the different SDRs. Originality/value – The paper adds to the scarce research available on the sustainability of protected areas in the Middle East region.
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Fitri, Yusriani, Rina Marlina, Yelfianita Yelfianita, Sufyarma Marsidin, and Rifma Rifma. "Literature Study: Utilization and Effective Management of School Operational Assistance (SOA) Funds." International Journal of Educational Dynamics 6, no. 2 (2024): 586–90. http://dx.doi.org/10.24036/ijeds.v6i2.463.
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The distribution of School Operational Assistance (SOA) funds by the government has so far not been able to fully overcome existing education problems. Ironically, the misuse and ineffective allocation of SOA funds adds to new problems. To prevent ineffective use of SOA funds, school principals are required to be competent as managers in the process of planning, organizing, determining direction, monitoring, and providing information in the form of financial reports. The method used in this research is literature study, namely the collection and analysis of information published in books and journals that are relevant and support the research topic and other written sources. Financial management in an educational institution aims to increase the effectiveness and efficiency of financial use, increase financial accountability and transparency, and reduce misuse of the education budget. To achieve effective results, the application of management principles in managing SOA funds is very important, namely planning, organizing, implementing, and controlling. Technical guidelines for the use of regular SOA funds must be carried out based on the principles of flexibility, effectiveness, efficiency, accountability, and transparency. Therefore, applying management principles in managing SOA funds is a crucial step to ensure that these funds are used optimally and on target to support improving the quality of education.
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Mumaw, Randall J., Emilie M. Roth, and Emily S. Patterson. "Lessons from the Glass Cockpit: Innovation in Alarm Systems to Support Cognitive Work." Biomedical Instrumentation & Technology 55, no. 1 (2021): 29–40. http://dx.doi.org/10.2345/0899-8205-55.1.29.
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Abstract Nurses working in the hospital setting increasingly have become overburdened by managing alarms that, in many cases, provide low information value regarding patient health. The current trend, aided by disposable, wearable technologies, is to promote patient monitoring that does not require entering a patient's room. The development of telemetry alarms and middleware escalation devices adds to the continued growth of auditory, visual, and haptic alarms to the hospital environment but can fail to provide a more complete understanding of patient health. As we begin to innovate to both address alarm overload and improve patient management, perhaps using fundamentally different integration architectures, lessons from the aviation flight deck are worth considering. Commercial jet transport systems and their alarms have evolved slowly over many decades and have developed integration methods that account for operational context, provide multiple response protocol levels, and present a more integrated view of the airplane system state. We articulate three alarm system objectives: (1) supporting hazard management, (2) establishing context, and (3) supporting alarm prioritization. More generally, we present the case that alarm design in aviation can spur directions for innovation for telemetry monitoring systems in hospitals.
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Funmilola Olatundun Olatoye, Oluwafunmi Adijat Elufioye, James Olakunle Oladapo, Ekene Ezinwa Nwankwo, and Chinwe Chinazo Okoye. "Human resources challenges in global health organizations: Managing a diverse and dispersed workforce." International Journal of Science and Research Archive 11, no. 1 (2024): 2033–40. http://dx.doi.org/10.30574/ijsra.2024.11.1.0272.
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In the dynamic landscape of global health organizations, Human Resources (HR) faces unique challenges in managing a diverse and dispersed workforce. This review explores the multifaceted issues that HR professionals encounter while navigating the intricacies of global health settings. One of the foremost challenges is the diversity inherent in the workforce of global health organizations. These entities often bring together professionals from diverse cultural, educational, and professional backgrounds, creating a melting pot of perspectives and approaches. HR must devise strategies to foster inclusivity, address cultural differences, and promote effective communication to harness the collective strength of this diverse talent pool. Furthermore, the dispersed nature of global health organizations presents a logistical challenge for HR management. With teams spread across different geographic locations, time zones, and cultural contexts, coordinating and integrating human resources practices becomes inherently complex. Virtual collaboration tools and innovative communication strategies become imperative to bridge the geographical gaps and create a cohesive organizational culture. Managing talent retention and development in such a context becomes crucial. HR professionals need to design policies and programs that cater to the professional growth and well-being of employees regardless of their physical location. This involves implementing virtual training programs, mentorship initiatives, and performance evaluation systems that transcend geographical boundaries. Moreover, compliance with local and international labor laws adds another layer of complexity to HR management in global health organizations. Navigating the legal landscape and ensuring adherence to diverse regulatory frameworks require a nuanced approach and continuous monitoring. Human Resources faces a myriad of challenges in global health organizations, from fostering diversity and inclusion to navigating the complexities of a dispersed workforce. Successfully addressing these challenges demands a strategic and adaptive HR approach, leveraging technology, cultural sensitivity, and innovative practices to create a unified and thriving global health workforce.
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Maxfield, Molly, Allie Peckham, Dara James, and Rachel Koffer. "AS MUCH AS I CAN PREVENT… I’M GOING TO DO IT: A QUALITATIVE ANALYSIS OF WAYS PEOPLE MANAGE DEMENTIA-RELATED ANXIETY." Innovation in Aging 8, Supplement_1 (2024): 527. https://doi.org/10.1093/geroni/igae098.1724.
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Abstract Alzheimer’s disease and related dementias (ADRD) are prevalent, without cures, and associated with declining independence. Beyond their cognitive effects, ADRDs can create social, psychological, and financial challenges for the individual diagnosed, their family, friends, and caregivers. Dementia-related anxiety (DRA) is the fear or anxiety about a current or future diagnosis of ADRD. The present study examined self-identified ways of managing DRA. Semi-structured qualitative interviews focused on thoughts and feelings about dementia among 50 community-dwelling adults (58 to 89 years old, M = 70.80, SD = 6.02) without dementia diagnoses. A reflexive inductive thematic approach examined ways people managed DRA. Based on an iterative process, we adopted and revised themes, ultimately identifying five themes: 1) monitoring cognitive status (e.g., self-monitoring or objective assessment), 2) active coping strategies (e.g., using external reminders, normalizing age-related change), 3) interpersonal relationships and support (e.g., anticipating benefit of support from others), 4) planning and preparing for potential outcomes (e.g., securing power of attorney and/or advance directives, saying goodbyes), and 5) personal responsibility to manage dementia risk or accept a diagnosis (e.g., lifestyle factors to reduce dementia risk, thereby reducing risk for burdening others). Findings suggest people use internal and external means for coping with DRA that are likely to vary in their usefulness. We consider these findings within the context of terror management theory and the lifespan theory of control, attending to potential clinical interventions for individuals experiencing DRA.
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Saed, Bani Amer, Hayajneh Ahmad, Almemeh Lena, et al. "Critical Determinants of Blood Pressure Control: The Impact of Lifestyle, Environment, and Other Parameters in Patients with Hypertension – A Jordanian-based Cross-Sectional Study." medtigo Journal of Medicine 2, no. 4 (2024): e30622413. https://doi.org/10.63096/medtigo30622413.
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This study investigates how exercise, lifestyle factors, and technology may assist hypertension (HTN). It focuses on measuring the impact of different types of exercise, their intensity and duration, hydration practices, social support, and the effectiveness of utilizing artificial intelligence (AI) devices for blood pressure monitoring. This cross-sectional study included 1002 individuals aged 30 to 70 who met strict inclusion criteria such as suffering from HTN and taking their medication regularly. The data required was quantitative and qualitative, obtained through both primary and secondary sources. A questionnaire was used for primary data collection, and data was gathered from primary, secondary, and tertiary healthcare facilities. Strength training and aerobic activities have a significant effect on lowering blood pressure (Cramer's V = 0.961), with a strong correlation. Patients who exercise for over 60 minutes, five times a week, have significantly lower blood pressure (BP) (Cramer's V = 0.838). The Dietary Approaches to Stop Hypertension, Dietary Approaches to Stop Hypertension (DASH) diet, low in sodium and rich in fruits and vegetables, is also associated with reduced BP (p<0.0001). Adequate sleep and the use of AI devices in BP monitoring also contribute to better BP management (p<0.0001). Conclusion: This study emphasizes the significance of regular aerobic activity, a balanced diet, and adequate sleep patterns in managing HTN. Furthermore, the employing of AI devices in BP monitoring, such as smartwatches, adds immensely to BP management and supports informed health decisions among individuals with HTN, highlighting its value.
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Roohi, Ghazal, Panner Selvam R, and Fares Najari. "Adverse Drug Reaction Monitoring of Anticancer Drugs in Hematology Department." International Journal of Medical Toxicology and Forensic Medicine 11, no. 3 (2021): 32776. http://dx.doi.org/10.32598/ijmtfm.v11i3.32776.
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Background: Cancer is among the leading causes of mortality in India. Studies have reported antineoplastic agents as the common class of drugs causing Adverse Drug Reactions (ADRs). The present study aimed to conduct active surveillance of ADRs of anticancer drugs in the hematology department. Methods: A prospective observational study was conducted in 136 patients with cancer and the incidence and frequency of ADRs were assessed. The study was conducted in 6 months in a multispecialty hospital. Results: Among 136 cancer patients, All was more prevalent (39.70%); CLL, Non- Hodgkin’s Lymphoma were less prevalent (0.73%). ADRs were more prevalent in the Pediatrics department, i.e., 18.53% of ADRs were observed in patients aged <10 years. ADRs in male patients constituted 54.39%, whereas it was 45.60% in female patients. Cytarabine caused the highest number of ADRs (34.48%). The most prevalent ADR was anemia (25.60%). Conclusion: Multiple ADRs were detected in cancer patients. We found that hematological ADRs were more prevalent. Most of the ADRs were possible reactions according to Naranjo and the World Health Organization (WHO) scales.
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Kaur, Kirandeep, Preet Kanwal, Pardeep Goyal, et al. "Spontaneous Adverse Drug Reaction Monitoring in a Tertiary Care Centre." Current Drug Safety 15, no. 3 (2020): 215–21. http://dx.doi.org/10.2174/1574886315666200731172405.
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Background and Objective: Adverse drug reactions (ADRs) are associated with increased economic burden on the society. Monitoring of ADRs can help in decreasing the incidence of preventable adverse reactions. Methods: Under Pharmacovigilance Program of India, collection and reporting of ADRs has been going on at Dayanand Medical College and Hospital since January 2011. Here, we have analyzed the individual case safety reports (ICSRs) reported and uploaded between January 2017 and June 2019 from our centre. The ADR form provided by PvPI was used for collecting information, and the causality assessment was done according to the WHO-UMC scale. Results: A total of 498 ICSRs were uploaded through Vigiflow software during this period. Highest number of ADRs were recorded in the age group of 31-45 years (29.01%) and the least number of ADRs were recorded in the children less than 15 years of age (6.76%). General Medicine ward reported the highest number of ADRs and the antibiotics were most commonly associated with ADRs (26.21%), followed by antipsychotics (13.83%) and NSAIDs (12.14%). More than 90% of ADRs were non-serious (93.17%) and most of the ADRs were skin and soft tissue related (49.20%). Conclusion: Spontaneous reporting among indoor patients shows highest number of ADRs with use of antibiotics and almost all of the ADRs were non-serious in nature. Almost half of the total ADRs were skin and subcutaneous tissue related. Continuous efforts are required for further strengthening of the pharmacovigilance program of India.
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Bhushan, Rajput* Neha Harad Dikshita Madhavi Aditya Yadav Pradnya Pophale Tejaswini Asawe. "Pharmacovigilance: Safeguarding Patients Through Drug Safety Monitoring." International Journal of Pharmaceutical Sciences 3, no. 4 (2025): 1171–77. https://doi.org/10.5281/zenodo.15185821.
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Pharmacovigilance promotes the responsible and safe use of medications. Pharmacovigilance requires the spontaneous reporting of adverse drug reactions (ADRs). ADRs are, nevertheless, significantly underreported. In developing nations, adverse medication responses have grown to be a serious issue. Pharmacovigilance knowledge could serve as the foundation for initiatives meant to increase reporting rates and lower ADRs.
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Mishra, P., P. Subish, S. Gupta, et al. "Pattern and economic impact of cutaneous adverse drug reactions: initial experiences from the regional pharmacovigilance center, Western Nepal." International Journal of Risk & Safety in Medicine 18, no. 3 (2006): 163–71. https://doi.org/10.3233/jrs-2006-379.
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The high mortality, morbidity and cost associated with adverse drug reactions (ADRs) represent an important public health concern. Cutaneous ADRs, the most common ADRs constitute of 15 to 30% of the total ADRs. The economic impact of cutaneous ADRs is not known. The present study analyzed the cutaneous ADRs reported to the Regional Pharmacovigilance Center, Manipal Teaching Hospital, Western Nepal and established their causality, severity, preventability and calculated the cost of drug therapy in managing them. The filled ADR reporting forms received by the center from September 2004 till August 2005 were analyzed. Additional patient details were obtained from the medical records department. Altogether, fifty seven ADRs were reported (men 22 and women 35). Mean ± SD age distribution was 30.21±17.89 years. Department of Dermatology reported 22 (38.59%) ADRs followed by Medicine department 14 (24.56%). Antibiotics were responsible for 18 (31.57%) cases of ADRs. Maculopapular rashes were reported in 18 (31.57%) of the cases followed by contact dermatitis in 9 cases (15.78%). The causality assessment (Naranjo algorithm) revealed that 47 (82.45%) ADRs could be probably attributed to the suspected drugs, 50 (87.71%) ADRs were Moderate (Level 3) [Modified Hartwig and Siegel scale] 2 (3.5%) of the ADRs could be definitely preventable (Schumock and Thornton scale). Fifty four (94.73%) patients were prescribed 181 drugs (average 3.17) for managing the ADRs. Antihistamines were most commonly used [56 (30.93%)] followed by corticosteroids [53 (29.28%)]. The average treatment duration was 13±7 days with an average cost burden of US$ 1.58±1.41 for drug therapy. Early detection and prevention may be beneficial in minimizing the economic implications of the cutaneous ADRs.
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Shah, Ram Chandra, Ragni Sinha, Chandan Mishra, and Jay Prakash Prasad Kumal. "Knowledge, Attitude and Practice of Adverse Drug Reactions (ADRS) Reporting in Nursing Staffs of Tertiary Care Hospital." Medical Journal of Eastern Nepal 1, no. 02 (2022): 38–43. http://dx.doi.org/10.3126/mjen.v1i02.51162.
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Background Adverse Drug Reactions (ADRs) are adverse consequences of drug therapy and are a major cause of morbidity and mortality. Approximately 2.9-5.6% of all hospital admissions are due to ADRs and up to 35% of hospitalized patients experience ADRs during their hospital stay. Therefore, the study assesses nurses’ knowledge, attitudes and practices (KAP) for monitoring and reporting spontaneous adverse drug reactions (ADRs). Methods In this observational study, 155 professional nurses with Proficiency Certificate Level (PCL), Bachelor Nurses and Masters working in various hospitals and academic institutes in Janakpur Municipality were selected to complete 19 pre-validated questionnaires on knowledge, attitudes and practice of ADR monitoring and reporting’ response. The data were converted by a predetermined scoring method and subjected to statistical analysis. Results Most participants from PCL Nursing (52.25%), participants from Bachelor Nursing (35.48%) and the fewest participants from Master Nursing (12.25%) were between 26 and 35 years old. Regarding ADRs knowledge, the majority of the Master Nurses (86.18%) answered the question correctly. ADR that reported regularly, most certificate nurses disagreed (33.3%) and more certificate nurses were neutral (38.2%) and some certificate nurses were agreed (28.3%). Most master nurses (63.1%) had patients with ADRs, but bachelor nurses (52.7%) and certificate nurses (64.2%) had not experienced any patients with ADRs in the past year. Master nurses (78.9%) were aware of the response to ADRs reporting and monitoring, but most certificate nurses (83.9%) and bachelor nurses (65.5%) were unaware of the ADRs reporting and monitoring response. Conclusion We conclude that KAP of ADRs in nurses is not sufficient especially in certificate and bachelor nurses. But master level nurses responded well. This is due to their knowledge, attitude and practices on ADRs reporting and monitoring.
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Di Stefano, Antonella, Massimo Gollo, and Giovanni Morana. "Improving QoS Management Using Associative Memory and Event-Driven Transaction History." Information 15, no. 9 (2024): 569. http://dx.doi.org/10.3390/info15090569.
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Managing modern, web-based, distributed applications effectively is a complex task that requires coordinating several aspects, including understanding the relationships among their components, the way they interact, the available hardware, the quality of network connections, and the providers hosting them. A distributed application consists of multiple independent and autonomous components. Managing the application involves overseeing each individual component with a focus on global optimization rather than local optimization. Furthermore, each component may be hosted by different resource providers, each offering its own monitoring and control interfaces. This diversity adds complexity to the management process. Lastly, the implementation, load profile, and internal status of an application or any of its components can evolve over time. This evolution makes it challenging for a Quality of Service (QoS) manager to adapt to the dynamics of the application’s performance. This aspect, in particular, can significantly affect the QoS manager’s ability to manage the application, as the controlling strategies often rely on the analysis of historical behavior. In this paper, the authors propose an extension to a previously introduced QoS manager through the addition of two new modules: (i) an associative memory module and (ii) an event forecast module. Specifically, the associative memory module, functioning as a cache, is designed to accelerate inference times. The event forecast module, which relies on a Weibull Time-to-Event Recurrent Neural Network (WTTE-RNN), aims to provide a more comprehensive view of the system’s current status and, more importantly, to mitigate the limitations posed by the finite number of decision classes in the classification algorithm.
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Reumerman, M., J. Tichelaar, M. C. Richir, and M. A. van Agtmael. "Medical students as adverse drug event managers, learning about side effects while improving their reporting in clinical practice." Naunyn-Schmiedeberg's Archives of Pharmacology 394, no. 7 (2021): 1467–76. http://dx.doi.org/10.1007/s00210-021-02060-y.
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AbstractManaging adverse drug reactions (ADRs) is a challenge, especially because most healthcare professionals are insufficiently trained for this task. Since context-based clinical pharmacovigilance training has proven effective, we assessed the feasibility and effect of a creating a team of Junior-Adverse Drug Event Managers (J-ADEMs). The J-ADEM team consisted of medical students (1st–6th year) tasked with managing and reporting ADRs in hospitalized patients. Feasibility was evaluated using questionnaires. Student competence in reporting ADRs was evaluated using a case-control design and questionnaires before and after J-ADEM program participation. From Augustus 2018 to Augustus 2019, 41 students participated in a J-ADEM team and screened 136 patients and submitted 65 ADRs reports to the Netherlands Pharmacovigilance Center Lareb. Almost all patients (n = 61) found it important that “their” ADR was reported, and all (n = 62) patients felt they were taken seriously by the J-ADEM team. Although attending physicians agreed that the ADRs should have been reported, they did not do so themselves mainly because of a “lack of knowledge and attitudes” (50%) and “excuses made by healthcare professionals” (49%). J-ADEM team students were significantly more competent than control students in managing ADRs and correctly applying all steps for diagnosing ADRs (control group 38.5% vs. intervention group 83.3%, p < 0.001). The J-ADEM team is a feasible approach for detecting and managing ADRs in hospital. Patients were satisfied with the care provided, physicians were supported in their ADR reporting obligations, and students acquired relevant basic and clinical pharmacovigilance skills and knowledge, making it a win-win-win intervention.
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Shin, Heejeong, and Su-Young Choi. "Firm-specific investor sentiment and stock price crash risk: The role of foreign investors in Korea’s stock market." Investment Management and Financial Innovations 19, no. 4 (2022): 309–26. http://dx.doi.org/10.21511/imfi.19(4).2022.25.
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Building on a prior study that documents that stock price crashes are positively associated with firm-specific investor sentiment (hereafter, the sentiment), this study further investigates the moderating effect of foreign investors on Korea’s stock market. This study hypothesizes that foreign investors as sophisticated participants are indifferent of the significant relationship between the sentiment and the stock price crashes. For firms listed on the KSE over the period of 2011–2019, the analysis findings show that the high stock crash risk attributable to the high sentiment is attenuated for firms with high foreign ownership. However, such moderating effect of foreign ownership disappears when taking foreign investment horizon into consideration. This implies that future stock crash risk reduction under the high sentiment is due to the corporate monitoring role of foreign investors, who are targeting a long-term investment horizon. This study adds to the literature on the role of foreign investors by suggesting that foreign investors act as a rigorous monitor helpful for managing stock price, rather than a price maker who is rational under the high sentiment.
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Hussain, Arif. "PROSPECTS OF CPEC AND ECONOMIC AND SOCIAL SUSTAINABILITY IN PAKISTAN." Journal of Research in Economics and Finance Management 1, no. 1 (2022): 13–25. http://dx.doi.org/10.56596/jrefm.v1i1.9.
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This paper gives a far-extensive examination of the China-Pakistan Economic Corridor (CPEC) and its possible effect on monetary and social sustainability in Pakistan. Through an analysis of the literature, it assesses the potential open doors and difficulties related to the task, like administration and institutional plans, ecological supportability, social and monetary effect, and international dangers. Furthermore, the paper presents suggestions to work on the possibilities of CPEC and sustainability in Pakistan, including strengthening governance and institutional arrangements, addressing environmental sustainability, ensuring social and economic impact, managing geopolitical risks, and enhancing research and monitoring. The study concluded that while CPEC has the potential for critical financial development and improvement, careful planning and management are necessary to ensure sustainable development and poverty reduction. It recognizes limits in the concentrate like information, time, extension, and predisposition, and prescribes regions for future exploration to fill these gaps. So, this study adds to the continuous discussion on CPEC's advantages and difficulties and its effect on financial and social development in Pakistan.
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Ejike Innocent Nwankwo, Ebube Victor Emeihe, Mojeed Dayo Ajegbile, Janet Aderonke Olaboye, and Chukwudi Cosmos Maha. "AI in personalized medicine: Enhancing drug efficacy and reducing adverse effects." International Medical Science Research Journal 4, no. 8 (2024): 806–33. http://dx.doi.org/10.51594/imsrj.v4i8.1453.
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Artificial intelligence (AI) is transforming personalized medicine by enhancing drug efficacy and reducing adverse effects, promising a new era of precision healthcare. This paper explores the role of AI in revolutionizing drug therapies by tailoring treatments to individual patient profiles, thereby optimizing therapeutic outcomes and minimizing risks. AI leverages vast amounts of medical data, including genetic information, electronic health records (EHRs), and real-time health monitoring data, to create comprehensive patient profiles. Machine learning algorithms analyze these profiles to identify patterns and correlations that might not be apparent to human practitioners. This enables the development of personalized treatment plans that consider a patient's unique genetic makeup, lifestyle, and existing health conditions. One of the critical applications of AI in personalized medicine is pharmacogenomics, which studies how genes affect a person’s response to drugs. AI can analyze genetic variations that influence drug metabolism, efficacy, and toxicity, allowing healthcare providers to predict which medications and dosages will be most effective for individual patients. This reduces the trial-and-error approach traditionally used in prescribing medications, thereby enhancing drug efficacy and reducing the incidence of adverse drug reactions (ADRs). AI also plays a significant role in drug repurposing and development. By analyzing existing drug data and patient outcomes, AI can identify new therapeutic uses for existing medications and predict potential side effects before clinical trials, accelerating the drug development process and reducing costs. Moreover, AI-driven predictive analytics can continuously monitor patient responses to treatment, adjusting drug dosages in real-time to maintain optimal therapeutic levels. This is particularly beneficial for managing chronic conditions such as diabetes, hypertension, and cancer, where maintaining the correct drug dosage is crucial for effective disease management. Despite its promise, the integration of AI in personalized medicine faces challenges, including data privacy concerns, the need for robust regulatory frameworks, and ensuring equitable access to AI-driven healthcare innovations. Addressing these challenges requires collaborative efforts from healthcare providers, researchers, policymakers, and technology developers. In conclusion, AI is at the forefront of personalized medicine, enhancing drug efficacy and reducing adverse effects by tailoring treatments to individual patient profiles. Continued advancements in AI technologies and supportive regulatory policies will be crucial in realizing the full potential of personalized medicine, ultimately leading to more effective and safer healthcare solutions. Keywords: AI, Drug Efficacy, Personalized Medicine, Enhancing, Reducing Adverse Effect.
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Sundaran, Siraj, Abhijith P. S, Aleena Alex, et al. "SPONTANEOUS ADVERSE DRUG REACTION REPORTING IN A TERTIARY CARE HOSPITAL IN CALICUT." Asian Journal of Pharmaceutical and Clinical Research 11, no. 8 (2018): 283. http://dx.doi.org/10.22159/ajpcr.2018.v11i8.26026.
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Objective: The study was conducted to assess the adverse drug reactions (ADRs) reported in a tertiary care hospital in Calicut.Methods: Spontaneous ADR reporting method was followed for the study. The ADRs reported by the health-care professionals, or the patients were confirmed with the physician-in-charge. Further, the assessments of type, severity, and preventability of reported ADRs were done using Wills and Brown classification, modified Schumock and Thornton severity scale, and modified Hartwig and Siegel preventability scale.Results: A total of 30 ADRs were reported. A study found that the incidence of ADRs was more in males (1.14%) when compared to females (0.79%). Geriatric patients showed more incidences of ADRs (1.04%) when compared to pediatrics (0.69%) and adults (1.02%). More number of ADRs was associated with antibiotics (23.33%) and anticonvulsants (23.33%) than another category of drugs. Based on type or mechanism involved 80% of ADRs were pharmacologically related (Augmented) ADRs. Severity assessment showed that 50% were mild, 46.67% were moderate, and 3.33% were severe. Assessment of preventability showed that 63.33% of ADRs were not preventable, 30% were preventable, and 6.67% were probably preventable.Conclusion: The study was useful in finding the age category and drugs that were more prone to ADRs. This will render precautions and monitoring in the future. The importance of ADR monitoring unit and aid of clinical pharmacist in the monitoring and assessment were very well considered during the study.
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Mudasir, Maqbool Dr. Umair Ikram Dr. Arslan Anwar. "ADVERSE DRUG REACTION MONITORING AND OCCURRENCE IN DRUGS USED IN PULMONARY DISORDERS." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 08 (2018): 8060–65. https://doi.org/10.5281/zenodo.1405117.
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<em>Drug-related problems, including adverse drug reactions (ADRs), contribute to a significant health- and quality issues. Based on prevalence studies in different settings, approximately 5 to 35% of hospital admissions are due to adverse drug reactions (ADR). An adverse drug reaction (ADR) is defined by the World Health Organization (WHO) as any noxious, unintended, or undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis, or therapy.</em><em> ADRs are considered as the fourth to sixth leading cause of death among hospitalized patients. About 2.9-5.6% of all admissions are caused by adverse related events, and approximately 35% hospitalized patients experience an ADR. </em><em>. ADRs not only increase the mortality and morbidity but also multiply the health care cost. ADR monitoring is primarily essential for drugs with narrow therapeutic index. Theophylline has been used for many years for the treatment of asthma and chronic obstructive pulmonary disease (COPD). The incidence of ADRs due to theophylline has been found to be 4.71%, of which nausea, loss of appetite (anorexia) and palpitation were common. The study of ADRs is essential in order to determine the incidence of ADRs in medical inpatients, estimate the contribution of ADRs to hospital admissions, characterize the types of ADRs observed, determines predisposing risk factors and to estimate the costs of ADRs in terms of ADR-related excess hospital stay.</em> <strong>Keywords:</strong><em> adverse drug reactions, Pharmacovigilance, pulmonary medicine</em>
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M, Kiran, and Nagabushan H. "Adverse Drug Reactions Monitoring in Patients on Antitubercular Treatment in Tertiary Care Hospital, Mandya." Biomedical and Pharmacology Journal 14, no. 02 (2021): 701–8. http://dx.doi.org/10.13005/bpj/2173.
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Background: Tuberculosis is one of the major public health concerns in India. Treatment of tuberculosis need multidrug combinations, which is associated with increased incidence of adverse drug reactions (ADRs). Hence there is a need of active monitoring for adverse effects in patients who are on antitubercular treatment (ATT). Objectives: To study the pattern of ADRs caused by antitubercular drugs and to assess causality, severity and predisposing factors. Methodology: A prospective observational study was conducted for 6 months in tertiary care hospital of Mandya. A total of 74 patients of tuberculosis who experienced ADRs were included in the study after obtaining informed consent. Their demographic, treatment and ADR data were collected and analysed. Causality was assessed using WHO scale and Naranjo’s algorithm, whereas severity was assessed by Modified Hartwig and Siegel scale. Results: Among 74 patients, 55(74.32%) were males and 19 (25.67%) were females. A total of 86 ADRs were recorded amongst 74 patients, as 11 patients experienced two ADRs. During intensive and continuation phase of treatment, 65 (87.63%) and 9 (12.16%)patients experienced ADRs respectively. Gastrointestinal side effects and hepatotoxicity were the most frequently observed ADRs with 23 (26.7%) each, followed by pruritus and rashes in 18 (20.93%) patients.63.51% of ADRs had an association with fixed dose combination (FDC) of isoniazid, rifampicin, pyrazinamide and ethambutol. As per WHO scale and Naranjo’s algorithm majority of ADRs were probable with 44 (59.45%) and 58 (78.37%) respectively. Most of the ADRs belonged to mild (67.56%) category as per Modified Hartwig and Siegel scale. Conclusion: ADRs induced by ATT are common. Hence counselling of patients regarding their life style along with early detection and management will minimize the occurrence of ADRs and improvethe adherence to treatment.
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Kim, Hyo Sung, Seok Kyeong Oh, Jae Eun Lee, Hyun Ah Lee, and Jae Gu Cho. "Anesthetic Management for a Pregnant Patient with Bilateral Vocal Cord Granuloma Using High-Flow Nasal Cannula Oxygenation with Oxygen Reserve Index Monitoring: A Case Report." Surgical Techniques Development 12, no. 3 (2023): 156–63. http://dx.doi.org/10.3390/std12030015.
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Anesthetic management for pregnant patients suffering from airway pathology poses unique challenges. The presence of a bilateral vocal cord granuloma adds further complexity to anesthetic management as it can potentially cause a compromised airway and respiratory distress. This case presents a pregnant patient with a bilateral vocal cord granuloma who underwent anesthesia using high-flow nasal cannula (HFNC) oxygenation and oxygen reserve index (ORi) monitoring. A 33-year-old pregnant woman, who underwent intubation six months ago, experienced hoarseness and was ultimately diagnosed with a bilateral granuloma. Due to the significant airway obstruction, neither intubation nor ventilation was feasible, thereby requiring a surgical intervention. Before the surgical removal, the patient’s oxygenation was ensured using HFNC oxygenation. After confirming the sufficient oxygenation of the patient with an ORi of 0.38, the operation commenced, and as it lasted approximately 3 min, the patient was able to tolerate the brief period without additional oxygen supply. Post-surgical excision, mask bagging, and HFNC oxygenation was resumed, driving the ORi to 0.39; then, the operation was resumed. Throughout the procedure, the SpO2 remained above 98. The combination of HFNC and ORi ensured adequate oxygenation and allowed for the early detection of hypoxemia during the procedure. This approach may be a good option for managing granulomas.
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Krishna, Sushma, Mahadevamma Lingaiah, C. Kavya, P. M. Mohammed Nehel, and M. Mohammed Faseeh. "Tapping the hospital antimicrobial stewardship initiatives for monitoring antibiotics-related adverse drug reactions." Journal of Patient Safety and Infection Control 11, no. 2 (2024): 37–40. http://dx.doi.org/10.4103/jpsic.jpsic_2_24.
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Adverse drug reactions (ADRs) are harmful effects caused by medications. ADRs may have a significant impact on patients’ quality of life while additionally adding strain on the healthcare system. ADRs are one of the most common prevalent causes of morbidity globally, and they will continue to be a challenging public health issue as medication becomes more advanced to treat diverse diseases in a growing population. A retrospective observational study was carried out in one of the super speciality hospitals of a South Indian City on the antibiotic-associated ADRs reported from 2017 to 2023. Amongst 68 ADRs, 40 (59%) were found to be associated with antibiotics. These ADRs were associated equally in males 20 (50%) and females 20 (50%). The reactions were more in the age group >50 years (n = 20, 50%), and lesser in children of 2–11 years (n = 6, 15%). A higher number of ADRs was caused by beta-lactam inhibitors (n = 13, 33%), followed by the quinolone group (n = 11, 28%). The severity of the reactions was found to be mild (n = 30, 75%) and severe (n = 1, 2.5%). The most affected organ system was the skin and cutaneous system. The results of the study highlight enhanced hospital pharmacovigilance monitoring of antibiotics-associated ADRs to ensure patient safety. Alternatively, hospital antimicrobial stewardship programs may lead a joint effort in preventing antibiotic-associated ADRs and multidrug-resistant infections.
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Schwier, Nicholas C., Katy Stephens, and Peter N. Johnson. "Management of Idiopathic Viral Pericarditis in the Pediatric Population." Journal of Pediatric Pharmacology and Therapeutics 27, no. 7 (2022): 595–608. http://dx.doi.org/10.5863/1551-6776-27.7.595.
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Idiopathic (viral) pericarditis (IP) is one of the most common etiologies of acute and recurrent pericarditis in children. IP is associated with significant morbidity, and recurrence rates of IP are high and require treatment to decrease risk of recurrence and pericarditis-related chest pain. Despite significant morbidity, sparse guidance exists to comprehensively address management of IP in children. The purpose of this review is to provide an overview of the pharmacotherapy of IP in children, including clinical pearls for managing pediatric patients. Clinicians should consider using the combination of colchicine and nonsteroidal anti-inflammatory drugs (NSAIDs) as first-line therapy, in order to reduce the risk of recurrence and foster symptom improvement in IP. Colchicine dosing may vary depending on patient age, weight, concomitant pharmacotherapies, and disease states. Choice of NSAID should be based on cost, tolerability, and adverse drug events (ADEs). Children should receive higher NSAID attack dosing for &gt;1 week to ensure a reduction in high sensitivity C-reactive protein concentrations and symptom relief. Corticosteroids should be considered last-line for treatment of IP in children, because they increase the risk of recurrence. Immunotherapies may be considered for children with multiple recurrences related to IP despite the use of NSAIDs, colchicine, and/or corticosteroids. Similar to adults, diligent monitoring should be implemented, to prevent drug-drug interactions, drug-disease interactions, and/or ADEs in children.
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&NA;. "Preventing and managing ADRs from immunosuppressive therapy." Reactions Weekly &NA;, no. 466 (1993): 2. http://dx.doi.org/10.2165/00128415-199304660-00002.
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&NA;. "News from ERS: Managing antiTB-induced ADRs." Reactions Weekly &NA;, no. 1325 (2010): 4. http://dx.doi.org/10.2165/00128415-201013250-00011.
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Duga, Alemayehu Lelisa, Francesco Salvo, Alexander Kay, and Albert Figueras. "Safety Profile of Medicines Used for the Treatment of Drug-Resistant Tuberculosis: A Descriptive Study Based on the WHO Database (VigiBase®)." Antibiotics 12, no. 5 (2023): 811. http://dx.doi.org/10.3390/antibiotics12050811.
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Background: The introduction of new drugs that increase the usage of repurposed medicines for managing drug-resistant tuberculosis (DR-TB) comes with challenges of understanding, properly managing, and predicting adverse drug reactions (ADRs). In addition to the health consequences of ADRs for the individual, ADRs can reduce treatment adherence, thus contributing to resistance. This study aimed to describe the magnitude and characteristics of DR-TB-related ADRs through an analysis of ADRs reported to the WHO database (VigiBase) in the period from January 2018 to December 2020. Methods: A descriptive analysis was performed on selected reports from VigiBase on the basis of medicine-potential ADR pairs. The ADRs were stratified by sex, age group, reporting country, seriousness, outcome of the reaction, and dechallenge and rechallenge. Results: In total, 25 medicines reported to be suspected individual medicines or as a fixed-dose combination in the study period were included the study. Pyrazinamide (n = 836; 11.2%) was the most commonly reported medicine associated with ADRs, followed by ethionamide (n = 783; 10.5%) and cycloserine (n = 696; 9.3%). From the report included in this analysis, 2334 (31.2%) required complete withdrawal of the suspected medicine(s), followed by reduction of the dose (77; 1.0%) and an increased dose (4; 0.1%). Almost half of the reports were serious ADRs mainly caused by bedaquiline, delamanid, clofazimine, linezolid, and cycloserine that are the backbone of the DR-TB treatment currently in use. Conclusions: A third of the reports required medication withdrawal, which impacts treatment adherence and ultimately leads to drug resistance. Additionally, more than 40% of the reports indicated that ADRs appeared two months after the commencement of treatment, thus it’s important to remain alert for the potential ADRs for the entire duration of the treatment.