Abstract : Background As per the census of 2001 geriatric population accounts for 7.4% of the total population which increases to 8.2% by 2011 and likely to be 10.7% by 2021. Aging is associated with decreased renal and hepatic clearance of drugs and about one third of the elderly patients are hospitalized due to adverse drug reactions and leading cause were polypharmacy and comorbidities. Objective The objective was to identify and spontaneous reporting of ADR observed in geriatric patients and to assess the influence of polypharmacy and co-morbidities causing ADRs. Methods A six months prospective study was conducted in the geriatric patient of medicine department, Pariyaram Medical College, Kannur (DIST) after obtaining the Ethical Approval. Study was based on the identification, reporting and assessment of ADR according to the inclusion and exclusion criteria. Any reaction noted will be brought into the notice of the physician and filled the notification form. These reports were coordinated during ward rounds and pharmacy practice activities. Informed consent shall be taken from the patient for suspected ADR before documentation. Data of each patient was collected using structured data collection form. The results were statistically analyzed using SPSS version 21. Results and Discussion A total of 203 geriatric patients, 148 patients were monitored during the study period. In 61 ADR reported; 62.29% were female and 37.70% male. Antibiotics were the most ADR causing class of drug and the gastrointestinal system(27.86%) was most affected. Majority of patient had comorbidity condition of diabetes(70.76%) and 93.6% of study population consumes more than 6 drugs. By applying Spearson’,s rho stastical method age was strongly correlated with polypharmacy(p=0.000). Causality assessment according to Naranjos scale observed that 18.03% of ADRs were definite , 52% possible and probable comprises 29.5%. Conclusion Polypharmacy comes with an increased risk for negative health outcomes such as higher healthcare costs, ADEs, drug-interactions, medication non-adherence, decreased functional status and geriatric syndromes. Another reason of ADR is comorbid condition. The available data suggest that a scope of closer pharmacovigilance studies are much needed in the older age group due to co morbidity and polypharmacy which can cause ADR that are preventable.

Keyword : Geriatric, Polypharmacy, Co-morbidities, Pharmacovigilance

Abstract : Patient safety is a new and challenging discipline in primary care. Medical students need to understand and demonstrate appropriate patient safety skills in professional education. Pre-clinical students at Oman Medical College (OMC) have clinical skills training in primary care as well as in the hospital. The present study aimed to seek pre-clinical medical students' perceptions of their individual performance at a range of safety skills. A cross sectional study conducted at OMC. Data was collected by self-administrated questionnaire to a simple random sample of 50 medical students in pre-clinical years after finishing Family Medicine rotation. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Most participants (88%) agreed the importance of patient safety. Self- rated general knowledge on patient safety on good level (72%) compared to (27%) for the specific knowledge issues score. In medical error management 75% willing to report medical errors, more than half willing to disclose error to patient and faculty and 89% agreed introducing patient safety topic in undergraduate medical schools curricula. Students had a favorable opinion of their own safety skills. However, specific knowledge question revealed some misconceptions. Most participants recognized the importance of patient safety topic in curriculum. Students are fair and honest to report medical errors. They considered competent physician don’t make errors.

Keyword : Patient safety, pre-clinical medical students, perception

Abstract : Uncontrolled diabetes for prolong period results in cognitive decline and memory loss. Decline in effectiveness of processing resources, thinking ability and to recall objects is thought to be a result of mismanagement of diabetes. Early identification of cognitive impairment (CI) and memory loss allows for timely prevention and better prognosis for patients and their caretakers. The aim of this study is to summarize research findings fromdeveloped and developing countries as well as from Pakistan regarding cognitive impairment and memory loss in diabetes mellitus. A total of 58 studies were reviewed regarding cognitive impairment and memory loss among diabetics. The review concluded that for successful management of diabetes, it is important to identify the degree of cognitive impairment and memory loss in patients. Regular screening for cognitive impairment among diabetes patients must be conducted in order to provide optimal patient care.

Keyword : Cognition, memory loss, diabetes mellitus, Pakistan

Abstract : Introduction: Coagulation disturbances are one of the markers of systemic inflammation. Aim: To evaluate the role of D-dimer (DD) in predicting severity and mortality of hospitalized patients with community-acquired pneumonia. Material and Methods:143 CAP patients hospitalized in the Clinic of Pneumology and Phthisiatrics at “Saint Marina” University Hospital were retrospectively studied. D-dimer was measured on admission by latex-enhanced immunoturbidimetric method with reference value of 0,232mg/L. The severity of CAP was determined by PSI, CURB-65 and IDSA/ATS criteria. Results: Patients were on mean age 62.12±15.54 years, 59.4% - male. Elevated levels of D-dimer were found in 86.70% of the patients. The mean DD in non-survivors was significantly higher than in survivors (2.19±2.01mg/L vs. 1.28±1.46mg/L, р<0.05). DD increased significantly with increasing the severity group according to PSI, CURB-65 and IDSA/ATS criteria, but the correlation coefficients were weak (r=0.25; r=0.23; r=0.22 resp., p<0.001). DD>1mg/L increased the risk for in-hospital mortality with OR 4.25 (1.48-12.14; p<0.01). Conclusion: D-dimer is able to predict severity and outcome of CAP.

Keyword : CAP, D-dimer, severity, mortality

Abstract : An adolescent girl should be made aware of the phenomenon of menstruation before menarche, so as to enable her to accept it as a normal developmental process and manage it appropriately. Less attention has been given to the effect that menarche itself and the management of monthly menstrual periods may have on school attendance, learning outcomes, and continued school enrollment. This study was done with the objectives of assessing the knowledge and practices of adolescent girls related to menstruation. It was carried out in school going adolescent girls. A pretested structured questionnaire was used to collect information on knowledge and practices of girls related to menstruation after taking informed consent. Majority of girls (78.8%) had knowledge about menstruation before attaining menarche. Main source of knowledge about menstruation was girls’ family (60.2%). Majority of girls (56%) felt that the duration of menses ranged between 7-8 days. Majority (95.8%) knew that menses occur once a month. Only 56% knew the right duration of normal menstrual cycles. During menstruation (31.2%) one third of the students skipped school. Almost 34% took medication for pain during menstruation without any prescription. It was found that 32.6% girls used heating pads and 35.1% girls used herbal remedies to get relief from dysmenorrhea. Most of the girls had knowledge on menstruation from their families. During menstruation one third of the students skipped school and took medication for menstrual pain without prescription. Herbal remedies were used by one third of girls to relieve this pain. Keywords: Menstruation, knowledge, practice, school, adolescent

Keyword : Menstruation, knowledge, practice, school, adolescent