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Cancer chemotherapy drug wastage in a tertiary care hospital in India-A 3-month prospective and 1-year retrospective study.

ABSTRACT: This study prospectively quantified wastage of cancer chemotherapeutic drugs in an oncology unit to find the associated cost in 3 months. Retrospective analysis of drug usage for 12 months was also conducted to determine the expected drug loss in 1 year. The effect of vial sharing was evaluated under the assumption of sharing. A significant drug wastage of 19.72% (95% confidence interval [CI], 14.52-24.93%) in 3 months and 17.14% (95% CI 14.69-19.59%) in 1 year occurred in our oncology unit. Number of vials purchased (r = 0.362, p < 0.01), weight (r = -0.146, P < .01) and body surface area (r = -0.26, P < .01) correlated with the drug wasted. Vial sharing assumption showed a 9% (95% CI, 2.5-15.5%) reduction in cost in 1 year.

SUBMITTER: Gopisankar MG

PROVIDER: S-EPMC6783588 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Cancer chemotherapy drug wastage in a tertiary care hospital in India-A 3-month prospective and 1-year retrospective study.

Gopisankar M G MG Wahlang Julie J Jagtap Vikas V Sarkar Chayna C Purnima Devi L L Harris Caleb C

British journal of clinical pharmacology 20190801 10

This study prospectively quantified wastage of cancer chemotherapeutic drugs in an oncology unit to find the associated cost in 3 months. Retrospective analysis of drug usage for 12 months was also conducted to determine the expected drug loss in 1 year. The effect of vial sharing was evaluated under the assumption of sharing. A significant drug wastage of 19.72% (95% confidence interval [CI], 14.52-24.93%) in 3 months and 17.14% (95% CI 14.69-19.59%) in 1 year occurred in our oncology unit. Num ...[more]

PMID: 31323137

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Project description:IntroductionSexual assault is an important health and social problem affecting young girls. The aim of the study is therefore to do a one-year retrospective review of documents of alleged sexual assaults managed at Saint Paulo's Hospital Millennium Medical College (SPHMMC) to determine survivors' characteristics, circumstances of the assault, and treatment offered.MethodsThis is a hospital-based one-year retrospective review of alleged sexual assault cases. The case records of survivors were retrieved, reviewed and information extracted analyzed using SPSS version 17. Characteristics of victims of the sexual assault, clinical presentation, and management provided were described by frequency and percentage distribution.ResultA total of 170 cases of alleged sexual assault who received care during the study period were identified. Around 96% of the survivors were female while there were 6 male cases. The mean age of the victims was 13 yrs. with a range from 2 to 25 yrs. About 23.6% of the victims were less than 10 years. Half of the victims were assaulted by neighbors (45%) followed by strangers (36.5%). The interval between the incident and presentation to the hospital ranged from 2 hours to 93 days (2224 hours) with an average of 98 hours. Most (93.0%) had one or more physical examination findings at presentation. Serology tests for HIV, Hepatitis B, and Syphilis were done in 97.3%, 88.7%, and 84.5% cases respectively. Urine pregnancy tests were done in 62.5% of the cases. Prophylaxis against HIV and STI prophylaxis was provided to 42% and 45% respectively. Social support/counseling was provided to 61% of the victims and legal evidence (certificate) was provided to 45.5% of the cases.Conclusion and recommendationsAlthough it is largely not reported by the victims, sexual assault is a grievous offense still happening constantly. Children and young girls remain the most vulnerable. There is inadequate forensic evidence collection, legal and medical care. There is also a delay in presentation to hospital by victims. Therefore, there is a need to have standardized protocols for comprehensive evaluation and care of the survivors. It is also imperative that a multidisciplinary approach like a one-stop clinic should be utilized to provide effective and efficient medical, social, psychological, and legal services. Finally, it is very necessary to increase public awareness and preventive interventions are required particularly to protect the vulnerable age group to enhance their safety.

Project description:Background: Salmonella serovars Typhi (S. Typhi) and Paratyphi A (S. Paratyphi A), the causative agents of enteric fever, have been routinely isolated organisms from the blood of febrile patients in the Kathmandu Valley since the early 1990s. Susceptibility against commonly used antimicrobials for treating enteric fever has gradually changed throughout South Asia since this time, posing serious treatment challenges. Here, we aimed to longitudinally describe trends in the isolation of Salmonella enterica and assess changes in their antimicrobial susceptibility in Kathmandu over a 23-year period.Methods: We conducted a retrospective analysis of standardised microbiological data from April 1992 to December 2014 at a single healthcare facility in Kathmandu, examining time trends of Salmonella-associated bacteraemia and the corresponding antimicrobial susceptibility profiles of the isolated organisms.Results: Over 23 years there were 30,353 positive blood cultures. Salmonella enterica accounted for 65.4% (19,857/30,353) of all the bacteria positive blood cultures. S. Typhi and S. Paratyphi A were the dominant serovars, constituting 68.5% (13,592/19,857) and 30.5% (6,057/19,857) of all isolated Salmonellae. We observed (i) a peak in the number of Salmonella-positive cultures in 2002, a year of heavy rainfall and flooding in the Kathmandu Valley, followed by a decline toward pre-flood baseline by 2014, (ii) an increase in the proportion of S. Paratyphi in all Salmonella-positive cultures between 1992 and 2014, (iii) a decrease in the prevalence of MDR for both S. Typhi and S. Paratyphi, and (iv) a recent increase in fluoroquinolone non-susceptibility in both S. Typhi and S. Paratyphi isolates.Conclusions: Our work describes significant changes in the epidemiology of Salmonella enterica in the Kathmandu Valley during the last quarter of a century. We highlight the need to examine current treatment protocols for enteric fever and suggest a change from fluoroquinolone monotherapy to combination therapies of macrolides or cephalosporins along with older first-line antimicrobials that have regained their efficacy.

Dataset Information

Cancer chemotherapy drug wastage in a tertiary care hospital in India-A 3-month prospective and 1-year retrospective study.

Publications

Cancer chemotherapy drug wastage in a tertiary care hospital in India-A 3-month prospective and 1-year retrospective study.

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