Background of the study: Depression is a prevalent mental disorder characterized by various symptoms, including low mood, lack of pleasure, changes in appetite and sleep, and difficulty concentrating. Antidepressants are commonly used to manage depression as well as other related disorders, such as anxiety and somatoform disorders. This study aimed to investigate the adverse drug effects experienced by adult patients who were using antidepressants at Chitwan Medical College Teaching Hospital in Nepal. Methods: This study was a retro-prospective, observational study consisting of 117 adult patients under antidepressant medication. The adverse drug profile for the patients was collected using an antidepressant side effect checklist developed by the NHS foundation trust. Statistical analysis was performed using SPSS version 20. Result: The study group consisted of adult patients using antidepressants at Chitwan Medical College Teaching Hospital, Chitwan, Nepal. The mean age of the group was 40.9 ± 12.8, with 63.2% females and 36.7% males. The most common conditions for which antidepressants were prescribed were depression (49.5%), anxiety disorder (31.6%), and somatoform disorder (13.6%). Amitriptyline was the most commonly used medication in monotherapy (64.1%), followed by escitalopram and sertraline. Dry mouth, weight gain, drowsiness, blurred vision, problems with sexual function, and an increase in appetite were the most commonly reported adverse effects. The incidence of certain adverse effects was higher in the multiple therapy group than in the monotherapy group (p < 0.05). Conclusion: The incidence of adverse drug effects is high in patients taking antidepressants, especially those receiving multiple medications. Educating patients about common side effects and prescribing monotherapy whenever possible are crucial in reducing the incidence.

Sickel cell disease (SCD) is a genetic potentially debilitating disease with global concern. Hydroxyurea is an oral therapeutic agent with proven laboratory and clinical efficacy for sickle cell anemia. It can be speculated that SCD tends to greatly deplete the finances of households in developing countries where there is high level of poverty and inequitable distribution of wealth and resources. To determine direct medical and non-medical cost, we conducted a study to compare standard fixed-dose hydroxyurea with dose escalation to the maximum tolerated dose. A concurrent mixed method design was conducted on patients visiting the Bheri Hospital of Nepalgunj, Nepal who came for checkup of SCD was the study population. The sociodemographic and patient-related questionnaires was utilized for the data collection. Data was analyzed using SPSS version23. Out of 80 patients, the 53.75 patients were male. The median value of Hbs was found to be 69.2. 36 patients were found to be in fixed dose group while other 48 patients fall under the dose escalated group. While observing the lab parameters hemoglobin and fetal hemoglobin is in increasing manner while other blood cell counts were decreased. More number of ADRs are observed in the fixed-dose group with vaso-oclusive pain as a major clinical complication in the people. The overall cost that a patient bear was found to be NRs. 57309.523 ± 16637.095 (i.e. around 600USD) while Nepal’s GDP per capita is around 1400 USD (based on 2023 data). The study suggests hydroxyurea dosing should be maintained properly, and evaluation of laboratory parameters and the clinical complications should be addressed properly. The economic burden seems to be high in the SCD patients. Implementing hydroxyurea, effective administration of other agents and utilizing rigorous treatment approaches have the potential to reduce the overall impact on both patients and healthcare systems.

Pregnancy is the period of time when a fetus develops inside a woman's uterus. When counting from the last menstrual cycle through delivery, a pregnancy typically lasts around 40 weeks, or slightly over 9 months. Pregnancy is divided into three trimesters, as described by healthcare professionals. First trimester: from conception to 12 weeks; second trimester: from 13 to 28 weeks; third trimester: from 29 to 40 weeks. Seizures are a defining feature of the illness, however not all seizures are caused by epilepsy, such as febrile seizures or seizures brought on by drugs. The multilevel categorization of epilepsies was developed to facilitate categorizing epilepsy in varied clinical contexts. There are three types of seizures: those with undetermined onset, generalized onset, and focal onset. The second level is epilepsy type, which introduces the new categories of generalized epilepsy, focal epilepsies, and unknown. A variety of seizure forms, including absence, myoclonic, atonic, tonic, and tonic-clonic seizures, can occur in generalized epilepsies. An epilepsy syndrome diagnosis comes in third place. An epilepsy syndrome is a collection of symptoms that includes seizure types, EEG patterns, and imaging characteristics that frequently co-occur. This review underwent a narrative evaluation, for which papers from the Cochrane library, PubMed, Google Scholar, and Web of Science were gathered. Epilepsy is treated with antiepileptic medications (AEDs). There is evidence that suggests some antiepileptic drugs (AEDs) increase the chance of congenital malformation and induce teratology. The risk of malformation is increased by medications including carbamazepine, phenobarbital, phenytoin, topiramate, and valproate, but not by lamotrigine, gabapentin, levetiracetam, oxcarbazepine, primidone, or zonisamide. Lacosamide, Eslicarbazepine, Clonazepam, Clobazam, and Rivaracetam did not either.