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BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with kidney damage. In India, only a few reports related to the risk of chronic kidney disease (CKD) with NSAIDs are available. The present study highlights the prevalence and pattern of NSAIDs-induced CKD adverse drug reactions in the Indian population. MATERIALS AND METHODS: The individual case safety reports (ICSRs) reported by the National Coordination Centre (NCC)-Pharmacovigilance Program of India to the Uppsala monitoring center Pharmacovigilance database system "VigiLyze" were analyzed by using the preferred term "Chronic Kidney Disease" and "NSAIDs" from July 1, 2011 to September 12, 2019. A total of 28 ICSRs of NSAIDs associated CKD ICSRs were analyzed retrospectively for age, gender, concomitant medication, seriousness, and other criteria. RESULTS: About 82% of CKD cases due to NSAIDs were in the age group of 40–80 years, in which 54% belong to male. About 43% of the patients had CKD due to the use of diclofenac, and almost 96% of the patients had oral dosage forms of NSAIDs. The main indications of NSAIDs in these CKD cases were generalized body pain and joint pain. About 79% case of NSAID-induced CKD were serious, among which 54% led to the hospitalization and further use of NSAIDs discontinued in 86% of CKD cases. CONCLUSION: The present study revealed that prolonged use of NSAIDs in chronic pain conditions was responsible for CKD. To reduce the risk of NSAIDs-induced CKD, health care professionals should take the necessary steps to improve patient safety. [ABSTRACT FROM AUTHOR]

COVID-19 has resulted in an unprecedented loss of human lives and sufferings across the world. It has resulted in the collapse of public health systems and economy across the globe. As most of the national health systems lack organized surveillance infrastructure, resources, and expertise to respond to a pandemic, most of the countries failed to mount an effective response to contain the spread of this virus initially. As primary healthcare (PHC) has better access to the community, the settings where PHC services are inadequate or weak, hospitals are overwhelmed with patients, thus overburdening, and wasting meager specialist resources. PHC interventions can manage mild to moderate cases (>80% of total cases) and their contacts, along with addressing the needs of general population while only severe cases may require specialized hospital care. As PHC interventions have huge potential to tackle this pandemic, strengthening and inclusion of PHC in pandemic response could play a significant role in relieving the workload on secondary and tertiary healthcare facilities and minimizing loss of lives and its short and long term socioeconomic consequences. This article explores the scope and importance of strengthening PHC in breaking the chain of the transmission of this infectious disease, building an adequate response to minimize its disastrous consequences and prevent future emerging and reemerging disease outbreaks, if any. [ABSTRACT FROM AUTHOR]

Misuse of antimicrobials has become one of the grave concerns of public health. In last two decades, this has been largely contributing in the emergence of antimicrobial resistance (AMR) among all the pathogens. A 2013 report of Centres for Disease Control and Prevention, USA figured that at least 2 million people get an antibiotic-resistant infection every year and as many as 23,000 people lost their life. A multi-country survey in Southeast Asia region conducted by World Health Organization (WHO) in 2015, identified several gaps in knowledge and awareness about the optimal use of antimicrobials and AMR. Following this, the Ministry of Health and Family Welfare (MoHFW), Government of India, developed National Action Plan in the year 2017 to combat AMR. Pharmacovigilance Programme of India (PvPI) being a flagship programme of MoHFW holds the responsibility of ensuring safety of medicines used by India population and has recently identified AMR as one of the strategic priorities. This article intends to provide insights of the recent attempts and deliberate efforts made by PvPI in the containment of AMR in India and it also intends to sensitize healthcare fraternity on restricting AMR in public interest. [ABSTRACT FROM AUTHOR]

BACKGROUND: To improve the public health and promote instant adverse drug reaction (ADR) reporting, a need to develop an ADR Pharmacovigilance Programme of India (PvPI) mobile app was identified by the National Coordination CentrePvPI (NCCPvPI) to serve the Pan India ADR reporting. The objective of this study was to develop an indigenous Googlebased Android mobile application known as "ADR PvPI" and to analyze the ADRrelated data reported through this mobile application on pilot basis. MATERIALS AND METHODS: The ADR PvPI mobile application was indigenously developed by NCCPvPI officials within 6 months. The study of spontaneous ADR reporting was carried out between September 2017 and September 2018. This article provides an overview of the salient features of ADR PvPI mobile application, guides on how to fillin ADRs, reporting trends of ADR, types of ADR as per System Organ Class and pharmacological classes of drugs. RESULTS: Till date, >5500 users have downloaded the app with an average rating of 4.26. In that tenure, 262 reports have been received through ADR PvPI mobile app. During the year 2017, 3.55% of reports were received through ADR PvPI mobile app and the percentage of reports received by 2018 was 96.45%. CONCLUSION: The frequency of ADR reporting has significantly increased over the past 1 year and should be promoted further through awareness and training programs. [ABSTRACT FROM AUTHOR]

Purpose: To detect the presence of viral RNA of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in conjunctival swab specimens of coronavirus disease-19 (COVID-19) patients.Methods: Forty-five COVID-19 patients positive for real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 in nasopharyngeal swab with or without ocular manifestations were included in the study. The conjunctival swab of each patient was collected by an ophthalmologist posted for COVID duty.Results: Out of 45 patients, 35 (77.77%) were males and the rest were females. The mean age was 31.26 ± 12.81 years. None of the patients had any ocular manifestations. One (2.23%) out of 45 patients was positive for RT-PCR SARS-CoV-2 in the conjunctival swab.Conclusion: This study shows that SARS-CoV-2 can be detected in conjunctival swabs of confirmed cases of COVID-19 patients. Though the positivity rate of detecting SARS-CoV-2 in conjunctival swabs is very less, care should be exercised during the ocular examination of patients of COVID-19. [ABSTRACT FROM AUTHOR]

Background: The basic principle of neuroanesthesia is to provide hemodynamic stability, provision of optimal operative conditions, maintenance of cerebral perfusion pressure, and cerebral oxygenation. Aim: This study was undertaken to see the effect of dexmedetomidine infusion on hemodynamics and its ability to act as an anesthetic adjuvant in patients undergoing supratentorial tumor surgery. Setting and Design: Prospective randomized control double blind study. Subjects and Methods: In this study, we compared two groups with 25 patients in each group. Group C patients received saline infusion during surgery and 4 µg/kg of fentanyl intravenously (i.v.) at the induction and at pin head application. Group D patients received dexmedetomidine infusion during surgery at the rate of 0.4 µg/kg/h and 2 µg/kg of fentanyl i.v. at the induction and at pin head application Statistical Analyses Used: Parametric data were analyzed using Student's t-test. The categorical data were studied using Chi-squared test or Fisher's test as appropriate. Results: The vitals remained within 20% of baseline in both groups during the study period except at the time of extubation where the rise in heart rate was more than 20% in control group. The requirement of thiopentone for induction was significantly less in dexmedetomidine group. In dexmedetomidine group, less number of patients required intraoperative fentanyl (P < 0.05), and the time to rescue analgesic was also more in Group D (P < 0.05). Conclusion: Dexmedetomidine infusion started before surgery maintains hemodynamic stability intraoperatively and is effective in attenuating the cardiovascular responses to intubation, skull pin application, and extubation. It decreases the requirement of other anesthetic agents as well. [ABSTRACT FROM AUTHOR]