Pharmacovigilance monitoring and treatment adherence in patients on anti-tubercular drugs.

BACKGROUND: Tuberculosis (TB) is a chronic infectious disease that involves 6-9 months regimen with different combinations of drugs. Poor adherence can lead to prolonged treatment, higher cost, spurt in new cases and the development of resistance. Directed Observed Therapy (DOTS) are recommended to reinforce adherence for the treatment of TB. Thorough literature reviews suggest limited studies on pharmacovigilance monitoring and treatment adherence in tuberculosis. METHODOLOGY: This prospective study was conducted on patients suffering from tuberculosis after obtaining written informed consent. The patients underwent a thorough history taking and clinical examination, the patients included in the study were followed up for a period of 4 weeks every 2 weeks. On each visit the patients were assessed for any adverse effects observed which was reported spontaneously by the patients. The patients were also administered Morris Medication Adherence Scale (MMAS-8) during each visit at 2 weeks and 4 weeks. RESULT: A total of 59 patients completed the study with mean age of 46 ± 18 years with of a total of 39 males and 20 females completed the study duration. The Mean Morisky's Medication Adherence Scale (MMAS-8) score at baseline was 4.09 ± 1.33 (Mean ± SD). The mean MMAS-8 score at baseline significantly (p < 0.05) improved to at the end of week 2 and further the scores were improved at the end of 4 week. Although there was no difference between the males and female neither at 2 weeks nor at 4 weeks. A total of 67 adverse events were reported by patients, out of whom 42 adverse events was reported at the end of 2 weeks and another 25 adverse events were reported at the end of 4 weeks. CONCLUSION: The results of our study showed that with each follow-up the adherence to therapy of patients increased giving more chance of completion of therapy.

Analysis of lung function and respiratory symptoms in brass/metal industrial workers of Moradabad, Uttar Pradesh, India.

Background: The job demands of some of the industries have been reported to be hazardous to the health and safety of workers. Workplace environmental hazards or occupational hazards are a globally major cause of disability and mortality among the working population. The present study was done to analyze the effect of exposure to metal dust on pulmonary function and respiratory symptoms. Materials and Methods: The study population selected as cases were 200 male mill workers working for at least 1-year duration (direct exposure) in the age group of 20-50 years, and controls were 200 age- and gender-matched male participants without any history of occupational or environmental exposure. A complete history was taken. Spirometry was done. Spirometric parameters studied were forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), ratio of FEV1 and FVC, and peak expiratory flow rate (PEFR). The spirometry data and baseline characteristics of the participants were compared using unpaired t-test. Results: The mean age of the participants of the study group and the control group was 42.3 years and 44.1 years, respectively. The majority of the study population belonged to the age group of 41-50 years. The mean FEV1 value among participants of the study group and control group was 2.69 and 2.13, respectively. The mean FVC value among participants of the study group and control group was 3.18 and 3.63, respectively. The mean FEV1/FVC value among participants of the study group and control group was 84.59% and 86.22%, respectively. The mean PEFR value among the study group and control group was 7.78 and 8.67, respectively. While analyzing statistically, mean lung functional tests were significantly lowered among the study group. About 69.5% of the participants of the study group thought it to be essential for making safety measures a necessity. Conclusion: The present study concluded that mean lung functional tests were significantly lowered among the study group. Despite the use of face mask, lung function abnormality was present in mill workers.

Résumé Contexte: Les exigences professionnelles de certaines industries ont été signalées comme étant dangereuses pour la santé et la sécurité des travailleurs. Les risques environnementaux sur le lieu de travail ou les risques professionnels sont une cause majeure d'invalidité et de mortalité au sein de la population active. La présente étude a été réalisée pour analyser l'effet de l'exposition à la poussière métallique sur la fonction pulmonaire et les symptômes respiratoires. Matériels et méthodes: La population étudiée sélectionnée comme cas était composée de 200 hommes travaillant dans des usines pendant au moins un an (exposition directe) dans le groupe d'âge 20-50 ans. Les témoins étaient 200 participants masculins appariés par l'âge et le sexe, sans aucun antécédent d'exposition professionnelle ou environnementale. Une anamnèse complète a été réalisée. Une spirométrie a été effectuée. Les paramètres spirométriques étudiés étaient la capacité vitale forcée (CVF), le volume expiratoire forcé en 1 s (VEMS), le rapport entre le VEMS et la CVF, et le débit expiratoire de pointe (DEP). Les données spirométriques et les caractéristiques de base des participants ont été comparées à l'aide d'un test t non apparié. Résultats: L'âge moyen des participants du groupe d'étude et du groupe et du groupe témoin était de 42,3 ans et 44,1 ans, respectivement. La majorité de la population étudiée appartenait à la tranche d'âge des 41-50 ans. La valeur moyenne du VEMS parmi les participants du groupe d'étude et du groupe témoin était de 2,69 et 2,13, respectivement. La valeur moyenne de la CVF parmi les participants du groupe d'étude et du groupe témoin était de 3,18 et 3,63, respectivement. La valeur moyenne VEMS/CVF chez les participants du groupe d'étude et du groupe témoin était de 84,59 % et 86,22 %, respectivement. La valeur moyenne de la PEFR parmi les participants du groupe groupe étudié et le groupe témoin était de 7,78 et 8,67, respectivement. Lors de l'analyse statistique, les tests fonctionnels pulmonaires moyens ont été significativement réduits dans le groupe étudié. dans le groupe d'étude. Environ 69,5 % des participants du groupe d'étude ont estimé qu'il était essentiel de prendre des mesures de sécurité. Conclusion: La présente étude a conclu que les tests fonctionnels pulmonaires moyens étaient significativement abaissés dans le groupe étudié. Malgré l'utilisation masque facial, les travailleurs de l'usine présentaient des anomalies de la fonction pulmonaire. Mots-clés: Poussière de métal dur, test de fonction pulmonaire, symptômes respiratoires.

Glutathione S-transferase gene polymorphism and asthma: a case-control study in a pediatric population.

Aim: To carry out a case-control study of the association of GST gene polymorphisms in pediatric asthma-related oxidative stress. Materials & methods: Asthma patients (n = 250) and age-matched healthy subjects (n = 250) DNA were genotyped for GSTM1/GSTT1 (+/+, +/-, -/+ and -/-) frequencies using multiplex-PCR and plasma oxidative stress markers (examined spectrophotometrically). Results: Asthma patients had significantly more common null-genotype GSTM1-/GSTT1- (10.4%; p = 0.002) and elevated levels of malondialdehyde, protein carbonyl and 8-hydroxy-2-deoxyguanosine as compared with controls. In addition, the level of plasma glutathione, GST activity and ferric-reducing ability were significantly decreased as compared with controls. Conclusion: Our data revealed significant associations between GSTM1-/GSTT1- genotype and oxidative stress markers in asthmatic children, which may very likely contribute to increased incidence of bronchial asthma.