Dinesh Kansal

infection remains a worldwide spread disease with a definitemorbidity and mortality.Indeed, this infection is the main cause of non-ulcer dyspepsia, peptic ulcers and gastric tumors, including bothlow-grade MALT-lymphoma and adenocarcinoma. A 65-year-old female patient visited outpatient department of Gastroenterology clinic for a routine follow-up after completion of 14-day triple drug therapy for . After a few days of empirical treatment for raised liver enzymes, her liver enzymes normalized. Clinicians should be aware about the rare adverse event during eradication treatment.   Keywords: H. pylori, Liver function, Liver enzymes

Introduction: Adverse effects following vaccination must be reported and assessed in order to promote the patient safety and well-being. Objective: The aim of this study was to observe the pattern of adverse drug reactions (ADRs) following ChAdOx1 nCoV-19 (COVISHIELD) Vaccine. Materials and Methods: Study was conducted at Dr. RPGMC, Kangra at Tanda, which has a dedicated COVID-19 hospital, ADR monitoring Centre, COVID-19 vaccination Centre & a hospital with 700 bedded multi-specialty tertiary healthcare Centre situated in North India. Assessment was carried-out for the pattern of ADRs reported by the volunteers receiving COVID-19; ChAdOx1 nCoV-19 (COVISHIELD) vaccine from January to December 2021. Data such as age, gender, drug intake, types of ADRs, treatment and outcome of the reactions were collected. Each reported patient was assessed individually. Causality assessment was done on WHO scale. ADR profiling on the basis of site, onset, organ system affected, duration, whether urgent referral was required or not and resolution of signs & symptoms. The data is analyzed and expressed as mean ± standard deviation & percentages. Results: A total of 21,115 volunteers got vaccinated at our Centre from 16 January 2021 to 31 December 2021. Less than 1% (201) vaccinees reported AEFIs and all those who reported AEFIs had mild symptoms and recovered. Immune system related adverse effects (55.2%) were most common. Fever, drowsiness, headache, vomiting, injection site pain/swelling/tenderness and body aches were the most commonly reported adverse effects. Conclusion: Reporting of vaccine adverse effects and availability of safety data on public platform is an important factor in increasing the vaccine acceptability by the people and henceforth better health. ChAdOx1 nCoV-19 COVISHIELD vaccine is proved to be a safe vaccine against COVID-19 in adults.   Keywords: AEFI, ChAdOx1, COVISHIELD, nCoV-19 & COVID-19

Introduction: Patient safety and well-being is favored by reporting adverse drug effects timely and precisely. Pharmacovigilance contributes to post-marketing surveillance and ensures that necessary changes may be done to the drug labels accordingly. Objective: The study was aimed at observing, analyzing and reporting various adverse effects due to prescribed drug intake for patient conditions and disease being treated at our tertiary healthcare institution. Materials and Methods: Study was conducted at Dr. RPGMC, Kangra at Tanda, which is a multi-specialty tertiary healthcare hospital with 700 beds and an ADR monitoring Centre situated in the lap of western Himalayas in North India. Pattern of ADRs reported by the volunteers receiving drug therapy from January to December 2021 was assessed. Data pertaining to age, gender, drug intake, types of ADRs, treatment and outcome of the reactions was collected. Individual assessment was done for each patient. WHO scale was used for causality assessment. ADR profiling was carried out based on site, onset, organ system affected, duration, whether urgent referral was required or not and resolution of signs & symptoms. The data was analyzed using Microsoft excel 2019 and expressed as mean ± standard deviation & percentages. Results: A total of 83 patients reported ADRs (adverse drug reactions). These were reported to IPC, Ghaziabad through our AMC (Adverse Drug Reaction Monitoring Centre) from 1 January 2021 to 31 December 2021. Gastro-intestinal system related adverse effects (35%) were most common followed by skin (22.9%) and CNS (12%) adverse effects. GI adverse effects included anorexia, dyspepsia, diarrhoea, oral ulcers, nausea, vomiting, weight-loss and raised liver function tests. Conclusion: ADRs occur commonly but are often undetected. Even if detected they remain underreported as most of the health care professionals are unaware about pharmacovigilance. Therefore, mass sensitization and reward to those who report ADRs vigilantly is the need of the hour to promote patient safety.   Keywords: Adverse drug effects, ADRs, Patient safety, Pharmacovigilance, WHO causality assessment

A case of central hypothyroidism, following controlled-release carbamazepine (CBZ-CR) monotherapy for focal seizure prophylaxis. A 19 years old woman, presented to the neurology department with history of three episodes of sudden onset, abnormal body movements during sleep. Patient was diagnosed as a case of focal seizures with secondary generalization and was prescribed tablet CBZ-CR 300 mg twice a day for seizure prophylaxis. 3 months later patient presented with complaints of facial hair growth and menstrual irregularities. The patient was seizure free and was continuing with the treatment. Blood biochemistry parameters indicated central hypothyroidism. According toWorld Health Organization Uppsala monitoring Centre (WHO-UMC) causality assessment, she was classified as ‘possible’ for carbamazepine-induced central hypothyroidism. Carbamazepine was discontinued. She was switched to tablet levetiracetam 500 mg twice daily, thyroxine 25 microgram once daily and clobazam 10 mg at bedtime.  Conclusion: Thyroid function tests should be monitored in patients receiving carbamazepine therapy. Keywords: Carbamazepine, Drug induced hypothyroidism, Focal seizure, Thyroid function tests, Porencephaly.

Background: Carbamazepine is used widely in focal seizures but has the disadvantage of frequent drug interactions. Levetiracetam is a novel antiseizure drug with better pharmacokinetic profile with less drug interactions and having broader therapeutic range. Aims: The aim of our study was to generate more evidence for better management of focal seizures with available anti-seizure monotherapy. Materials and Methods: It was a randomized, prospective, open label, comparative interventional study, conducted at Dr. R.P.G.M.C, Kangra at Tanda. 38 participants received tablet levetiracetam (LEV) 1000 mg/day and 36 participants received tablet controlled-release carbamazepine (CBZ-CR) 600 mg/day. Results: CBZ-CR group had significantly higher CNS depression as compared to LEV (p=0.027). Hematological adverse effects with CBZ-CR were reversible. Both the drugs were safe on kidney and liver. 22 (66.7%) patients in LEV group and 26 (78.8%) in CBZ-CR group remained seizure free. QOL: Both the drugs significantly improved QOL. Pharmacoeconomics: CBZ-CR costed significantly lower than LEV (p Conclusion: Both the drugs are well tolerated and equally efficacious in controlling focal seizures. Quality of- life has improved significantly in both the groups. CBZ-CR is pharmacoeconomically better than LEV for treatment of new onset focal seizures in adult patients. Keywords: Controlled release carbamazepine, Epilepsy, Focal seizure, Levetiracetam, Pharmacoeconomics.

Levetiracetam has been associated with aggressive behavior and mania.We are reporting a case of agitation and aggressive behavior following levetiracetam monotherapy for focal seizure prophylaxis. A 48 years old man, who presented to the neurology department with history of four episodes of sudden onset abnormal body movements. Patient was diagnosed with focal seizures with secondary generalization and was prescribed tablet levetiracetam 500 mg twice a day for seizure prophylaxis. Three weeks later patient presented with complaints of excessive sleepiness during daytime, agitation and aggressive behavior, though seizure free. According to World Health Organization Uppsala monitoring Centre (WHO-UMC) causality assessment system the case was classified as probable/likely for levetiracetam-induced altered behavior. Levetiracetam was discontinued, and tablet  carbamazepine controlled-release 300 mg twice daily was substituted. Within 2 days of switching therapy the agitation and aggression reduced substantially. Although levetiracetam has fewer side effects than traditional antiepileptic medications, but it is imperative to continuously monitor the patient for infrequent adverse effects also, so that required modifications to drug label may be done. Keywords: Aggression, Agitation, Altered behavior, Levetiracetam.

This is a case series of 4 patients who developed leukopenia on, controlled-release carbamazepine (CBZCR) monotherapy for focal seizure prophylaxis. All 4 cases (2 males and 2 females), presented to the neurology department with history of episodes of sudden onset, abnormal body movements. Patients were diagnosed as cases of focal seizures and were prescribed tablet CBZ-CR 300 mg twice a day for seizure prophylaxis. One month later patients presented for follow-up and were continuing with the treatment. Blood biochemistry parameters indicated leukopenia with total leukocyte count less than 4000 per mm3. According to World Health Organization Uppsala monitoring Centre (WHO-UMC) causality assessment, all 4 cases were classified as ‘probable/likely’ for carbamazepine-induced leukopenia. Carbamazepine was continued and total leukocyte count gradually recovered on 3-months follow-up. Conclusion: Total leukocyte count should be documented before initiating carbamazepine therapy. Patients with pre-existing leukopenia should not receive carbamazepine. All patients receiving carbamazepine should be monitored for leukocyte count in addition to other blood biochemistry parameters. Keywords: Carbamazepine,Drug induced leukopenia, Focal-seizure, Total leukocyte count.

Objectives: To analyse the utilization of outpatient eSanjeevani Telemedicine Service during COVID pandemic in a public healthcare institution in North India by profiling the attributes of patients availing online video consultation in terms of gender, age, urban-rural, organ-system involvement, speciality of OPD service given and prescription analysis. Materials and Methods: This is a descriptive, cross sectional study done at Dr. Rajendra Prasad Govt. Medical College which served as a hub in a hub & spoke type model for rendering online OPD consultations; on a software platform “eSanjeevani” developed by Centre for Development of Advanced Computing (C-DAC) Mohali. Data from 206 audio+video based online tele-OPD consultations & their prescriptions were analysed. Results: Out of a total 206, 114 (55%) were males and 92 (45%) were females. Mean ± S.D. age of patients was 42 ±19.6 years. 146 (71%) connected from rural area and 60 (29%) from urban area. 38 (18%) patients required to be referred to the health-care centre and 46 (22%) patients required a review after blood biochemistry investigations. 76 (37%) were from district Kangra of Himachal Pradesh. The most common organ system involved was musculoskeletal system (19%) followed by skin (18.4%) and gastrointestinal system (16%). The most commonly prescribed class of drugs were NSAIDs & analgesics (36%) antimicrobials (23%) and antihistaminics (18%). Conclusion: Telemedicine is an innovative solution to many of the challenges posed by COVID-19 pandemic. It can help substantially in decreasing the OPD workload in hospitals & decreasing infection chances for both patients & hospital staff. Keywords: COVID- 19, Remote Consultation, Teleconsultation, Telemedicine.

Background: Corona Virus Disease (COVID-19) was declared as Global Pandemic by W.H.O. on 11th March 2020. As nationwide lockdown was imposed from 21st March 2020 in India, teleconsultation project known as eSanjeevani: Stay Home OPD” was launched by Honourable Union Health Minister. This facility was also started by the Department of Health & Family Welfare, Govt. of Himachal Pradesh at our center; Dr. Rajendra Prasad Govt. Medical College (Dr. RPGMC), Kangra at Tanda from 20th April 2020 onwards. Aim & Objective: To analyse the parameters influencing teleconsultation service from the perspective of patients during Covid-19 pandemic. Materials and Methods: This cross-sectional descriptive study was conducted through a semi-structured 10-point feedback questionnaire. The feedback was collected telephonically. A total of 131 responses were noted and analysed accordingly. Results: Out of 131 patients, 71 (54%) were males and 60 (46%) were females. All of them 131 (100%) accepted the legibility of e-prescription, and the majority (91%) of them were comfortable in procuring (downloading) the same. (83%) respondents preferred teleconsultation services over conventional OPD based services and (98%) patients also recommended teleconsultation platform to others. Conclusion: Mean rating score was 8.9±1.04 out of 10 which clearly shows that majority of patients were satisfied with teleconsultation services availed by them through Dr. RPGMC Tanda hub. Keywords: COVID- 19, Pandemics, Remote Consultation, Patient Satisfaction, Electronic Prescribing, eSanjeevni OPD.

Introduction: Dipeptidyl peptidase-4 are a relatively new class of oral antihyperglycemic agent that enhance insulin secretion by reducing degradation of endogenous glucagon-like peptide 1. Currently, sitagliptin, vildagliptin, saxagliptin, linagliptin and alogliptin are approved in India, USA and Europe for the use in patients with type 2 diabetes. In this study we have tried to assess the safety of saxagliptin used in patients of type 2 DM who were previously on metformin monotherapy. Materials and Methods: A total of 35 patients who were previously on metformin montherapy with uncontrolled diabetes were enrolled. Patients were started with saxagliptin (2.5 mg OD) and were followed up at 1st, 3rd and 6th months for the estimation of Liver Function Test (SGOT, SGPT, Bilirubin direct & indirect), Renal Function Test (BUN and Sr. Creatinine). During the follow up period patients were also assessed for the adverse drug reactions. Results: Male and female patients mean age SD (61.42 yrs 6.99 and 55.93 yrs 5.74 respectively). The mean significant decrease in values from baseline at 24 weeks were seen for SGOT, SGPT, Blood urea nitrogen and serum creatinine. Conclusion: The combination of saxagliptin plus metformin for the treatment of type 2 diabetes offers an oral treatment regimen that is safe and well tolerated. Keywords: Saxagliptin, Uncontrolled type 2DM safety knee arthralgia.

Background: Antibiotics are most commonly used prophylactically in a surgical set up. Avoidance of infection helps in early wound healing. Various guidelines are available for the use of antibiotics for surgical prophylaxis. Indiscriminate use of wide spectrum, newer antibiotics has lead to the problem of antibiotic resistance. Our aim was to evaluate the gap between the guidelines and the choice of antibiotics in a tertiary care hospital located in the sub Himalayan area. Materials and Methods: Data of all the patients who underwent surgery was analysed. Results: Record sheets of total 746 cases were included in the study. 376 (50.4%) patients were males and 370 (49.6%) were females. Maximum numbers of patients were from age group 36-45 years. Mean age SD of patients was 40.57 17.46. 572 (76.6%) patients stayed in hospital for 2 to 10 days, 138(18.5%) for 11 to 20 days, 24(3.3%) for 21 to 30 days, 6(.8%) for 31 to 40 days and 6 (.8%) for>40 days. 274 (36.6%) patients suffered from Hepatobiliary diseases, appendicitis was in 99 (13.3%), gastro-intestinal diseases in 98 (12.2%), hernias in 93 (12.47%), urinary system diseases in 30 (4.21%), male genital system diseases in 28 (3.75%), breast diseases 27 (3.62%), rectal and peri-anal diseases in 25 (3.35%), spinal diseases 16 (2.12%), brain diseases 14 (1.88%) other diseases in 43 (5.76%). Commonest antibiotic used was cefuroxime. Conclusions: The hepatobiliary disease was the commonest reason to undergo surgery. Keywords: Surgical prophylaxis, Rational use of antibiotics.

Introduction: Type 2 diabetes affects millions of people worldwide and significantly contributes to morbidity and mortality of those affected by it. Current guidelines recommend individualized treatment regimens following first line metformin therapy. Saxagliptin, a dipeptidyl-peptidase 4 inhibitor, provides a secondary mechanism of action to decrease hyperglycemia when used in combination with metformin. In this study we have tried to assess the efficacy of saxagliptin in patients of type 2 DM. Materials and Methods: A total of 35 patients were enrolled who were on metformin monotherapy and with uncontrolled diabetes. Patients were given saxagliptin 2.5 mg once a day. Patients were followed up at 1st, 3rd and 6th month and HbA1c, FPG and 2h-PG estimation was done during the follow up period.  Results: The mean age SD in male and female patients was 61.42 yrs 6.99 and 55.93 yrs 5.74 respectively. The mean change in value from baseline at 24 weeks was 10.7%, 16.48% and 21.63% for HbA1c, FPG and 2h-PG respectively and 20% of patient had achieved HbA1c Conclusion: Saxagliptin has shown an improvement in glycemic index (HbA1c, FPG, 2h-PG) during 6 months of treatment in patients of type 2 DM. Keywords: Saxagliptin, Uncontrolled type 2DM, Efficacy.

Introduction: Pain and inflammation are a day to day affliction for all living beings. Mankind has for years been trying to relieve the agony of pain & inflammation through various means with a large amount of success. Still we have not been able to produce the ideal analgesic or the ideal anti-inflammatory drug. The objective of this study was to evaluate a saponin, albichinoside, with respect to its ability to relieve pain and /or show anti-inflammatory activity. Materials and Methods: The study was conducted on rats. The saponin was evaluated for its effects on acute, sub-acute, chronic and immunological inflammation by using standard anti-inflammatory study protocols. Results: The test substance showed significant inhibition of acute, sub-acute and chronic inflammation produced by immunological and non-immunological methods in rats. These activities were qualitatively less as compared to indomethacin. This activity was like that of non-steroidal anti-inflammatory agents. Conclusion: The test substance has moderate anti-inflammatory activity which could be by means of inhibition of prostaglandin synthesis and the complement. Keywords: Saponin, Anti-inflammatory, Animals.

Introduction: The cardio-vascular system being the basis of life along with the respiratory system has always been the centre of attention for researchers. Efforts have been made for ages to prop up the failing heart or to regulate its normal beat & rhythm so that life could be extended. A major source of drugs for the heart is the plant kingdom. With this in mind a saponin from a plant called Albizzia chinensis Merr. was taken up to profile its cardiovascular activities. Materials and Methods: Albichinoside (ALB), the test substance was evaluated for its cardio-vascular activities in dogs, rabbits, rats and frogs. The parameters were its effects on the rate, rhythm and tone of heart, blood pressure and studies on the blood vessels. Results: The test substance produced hypotension, increase in tone & force of contraction of the heart, and dilatation of the blood vessels, without any effect on the heart rate. Conclusions: The compound showed immediate and prolonged hypotension along with cardiotonic effect and vasodilatation. Keywords: Saponin, Cardiovascular system, Animals.

Introduction: To know the Neuropharmacological effects of Albizzia chinensis extract in rats and mice. Materials and Methods: The test compound was evaluated experimentally for its neuropharmacological activities in rats and mice. Blind neuropharmacological screening, potentiation of barbiturate hypnosis, stimulation of the central nervous system, maximal electroshock and pentylenetetrazol induced convulsions, analgesic activity were studied. Results: The compound potentiated pentobarbital hypnosis, reduced spontaneous motor activity, antagonized amphetamine induced hyperactivity, blocked the conditioned avoidance response without affecting the unconditioned response and showed analgesic activity by the tail-flick method but not in hot plate model in the experimental animals. Conclusion: The compound is similar to chlorpromazine and morphine. Keyword: Saponin, Central nervous system, Animals.

Introduction: Diacerein and oxaceprol are frequently used for the treatment of Grade-I & II osteoarthritis of knees. Diacerein acts by blocking the action of interleukin-1 whereas oxaceprol prevents leukocyte infiltration in the synovial joints. Both the drugs are effective. But there are few comparative studies regarding safety and efficacy of these two drugs. Hence we planned this study. Materials and Methods: An open label randomized comparative study was conducted by the departments of Pharmacology and Orthopedics at Dr RPGMC, Tanda, H.P, after taking permission from the IEC. Patients were diagnosed clinically as per American College of Rheumatology (ACR) guidelines and graded radiologically as Grade I & II osteoarthritis of the knee joint based on Kellgren and Lawrence classification. Then considering exclusion criteria, patients were enrolled after taking written informed consent. 31 and 29 patients were enrolled in diacerein and oxaceprol groups respectively. Tab diacerein 50 mg and oxaceprol 200 mg were prescribed twice daily for three months in respective groups. One patient dropped out in each group, who opted for operative intervention after a few days of enrolment. Efficacy was assessed clinically by WOMAC scale during their follow up at three months. Safety was evaluated clinically considering adverse effects and by complete haemogram & blood biochemistry. Results: In diacerein-group, WOMAC score (mean ± S.D.) improved from 48.77± 18.17 to 29.40 ± 19.94 (p-value = 0.00001) and in oxaceprol group from 42.59 ± 19.49 to 26.58 ± 16.83 (p-value = 0.00001). No adverse effect was reported in any group. Conclusion: Both medicines are almost similar in safety and efficacy. Key words: Diacerein, Oxaceprol, Osteoarthritis of knee.

Objectives: To know the Impact of Mass Media on Knowledge attitude and practices (KAP) amongst the ANC mothers attending the ICTC at DrRPG Medical College, Tanda. Materials and Methods:This was a Hospital based, cross sectional study. The data was collected from pregnant women attending outpatient antenatal care (ANC) with prior written informed consent, from August 2017 to September 2017. A semi structured survey questionnaire was prepared for the study containing 54 questions regarding demographic information, HIV/STD information sources, HIV transmission knowledge, Misconceptions and attitude towards PLHIV. The questionnaire was administered as a face-to-face personal interview, and participant answers were filled in by interviewers. Results:Mass media sources, such as TV programs, newspapers and magazines, were more frequently identified as the channels for HIV information than interpersonal sources, such as friends and service providers. Exposure to multiple sources of HIV information (where at least one source is mass media) was significantly related to HIV knowledge. Yet it is observed that the knowledge of transmission of HIV from mother to child is seen less than other mode of transmission amongst the ANC mothers. It is also seen that though the mothers know that the HIV testing is required but are not aware about the ICTC and its role.  Even after so much of communication regarding the misconceptions, some misconceptions still exist among the ANC mothers. Conclusion: Even though mass media have played important role to increase knowledge about HIV, there is need to create a supportive health promotion education mechanism in the form of Health educators at grass root level, who can do intensified social behavioural communication campaigning to  bring about the expected behaviour changes by providing correct knowledge about the mother to child transmission of HIV/AIDS, Use of Condom, and to remove the misconception regarding the mode of transmission of the HIV/AIDS. Keywords: HIV, Mass media, Knowledge

 Objectives: Assessment of Health Related Quality of Life (HRQoL) of drug resistant tuberculosis patients at the start of treatment under PMDT regime. Materials and Methods: This observational study was conducted on a cohort of 172 drug resistant tuberculosis (DR-TB) patients at the time of registration under PMDT regime. Patients who started their treatment between January 2016 and December 2016 were included in the study after approval from IEC. A validated WHOQOL-BREF questionnaire was used for interviewing the patients. This questionnaire assesses HRQoL on 0-100 transforming scale in four domains – Physical, Psychological, Social relationship and Environmental. Results: Out of 172 participants, 50 (29.1%) were females and 122(70.9%) were males. Their mean age±SD was 40.23±15.77 years. 77.9% participants were married. 97.7% of them were residing in rural areas. Most of the participants were from district Mandi (33.1%) and Kangra (20.9%). Scores of Physical domain were 39.76±13.88; Psychological domain were 37.23±14.89; Social relationship domain were 43.28±13.48 and Environment domain were 50.66±9.13. Overall HRQoL scores were 42.73±10.11. Conclusion: Chronic diseases like tuberculosis affect all domains of HRQoL and there is need to consider HRQoL domains of patients of DR-TB along with smear positivity and mortality to evaluate the success of any national heath programme. Keywords:Drug resistant tuberculosis, Health related quality of life, WHO-QOL BREF     

Introduction: Diabetes is characterized by chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. This study is an attempt to show an improvement in lipid profile (TC, TG, LDL and HDL) in patients of type 2 diabetes mellitus who were previously on metformin monotherapy with uncontrolled diabetes. Material and method: A total of 30 patients were enrolled who were on metformin monotherapy and with uncontrolled diabetes. Patients were given metformin 500 mg twice a day and saxagliptin 2.5 mg once a day. Patients were followed up at 1st, 3rd and 6th month and lipid profile (TC, TG, LDL and HDL) estimation was done during the follow up period. Results: The mean age ± SD in male and female patients was 61.42 yrs ± 6.99 and 55.93 yrs ± 5.74 respectively. The mean change in value from baseline at 24 weeks was TC = 9.66%, TG = 9.40%, LDL = 14.87%, HDL = 5.63%. A highly significant difference has been seen at 0 v/s 1, 0 v/s 3 and 0 v/s 6 months in TC, TG, LDL and HDL values. Conclusion: Saxagliptin has shown an improvement in lipid profile (TC, TG, LDL, HDL) during 6 months of treatment in patients of type 2 DM. Keywords: Saxagliptin, Uncontrolled type 2DM, Metformin, Lipid profile.

Introduction: Adverse events can lead to admission in hospital, prolongation of hospitalization, increase in investigations as well as treatment costs, deformities, danger to life and even death. Objective: The aim of this study was to conduct adverse drug reactions (ADRs) monitoring in various departments of a tertiary care teaching hospital. Methods: A retrospective observational study was conducted on ADRs reported in adverse drug monitoring center of our hospital from April, 2016 to December, 2016. Data such as age, gender, diagnosis, drug intake, types of ADRs, treatment and outcome of the reactions were collected. Each reported patient was assessed individually. Causality assessment was done on Naranjo’s probability scale. Modified Hartwig’s criteria were used to assess the severity of ADRs. Results: A total of 173reports were studied. 65(38%) patients were males and 108 (62%) were females. The majority of ADRs were due to cancer chemotherapy agents in 87(50%), followed by anti-tubercular drugs in 22(13%), antimicrobial agents in 22 (13%) and anti-retroviral drugs in 16(9%).Out of total 574 events 192(34%)complaints comprised of gastro-intestinal manifestations. On Naranjo’s probability scale, 111(64%) reactions were probable, 54 (31%) as possible and 8 (5%) as certain. According to Modified Hartwig’s criteria 130 (75%) reactions were mild, 29 (17%) were moderate and 14(8%) were severe. Conclusion: Health-care providers will have to do vigilant monitoring and reporting of ADR´s. Keywords: Pharmacovigilance, Adverse drug reactions, Chemotherapy, Causality assessment, Tertiary care teaching hospital.