European Journal of Molecular & Clinical Medicine

In the recent past years, although the use of herbal plant products and supplements has increased to a large extent, overall only less than 80% of people rely on them to provide some basic healthcare services. Despite the fact that treatments including these agents have shown promising potential with their efficacy, many of them remain experimental and their use is poorly monitored. As a result, this often led to inadequate information about their mechanism of action and lead to potential adverse reactions, contraindications and interactions with existing pharmaceutical drugs and functional foods. The use of herbal plant medicine and dietary supplements can be risky as they are not subject to review by the Federal Drug Administration. Therefore, safety of herbal plants continues to be a major issue with the use of herbal remedies, where it becomes necessary. Owing to the lack of information about medicinal plants, may results in mistaking plants that contain toxins. This review discusses toxicity-related issues and major adverse effects arising from the use of herbal medicinal products and also highlights some important challenges related to the misidentification of herbal plants.

Introduction: Patient safety is the primary objective of health care. Success and failures are part of it. Adverse events can be controlled but cannot be eliminated. They should be reported, documented, and studied. Such data is important to monitor hospital performance and also they serve as a medium for training, simulation and improvement in standards of anaesthesia care.
Material and method: An observational retrospective study was conducted in a teaching tertiary level government hospital from patient records who underwent adverse events or deaths related to anaesthesia over one year from October 2016 to September 2017. Type of adverse events and their relation to ASA grading, type and speciality of operation, age, sex and comorbidities of the patient, time of critical incident when occurred with relation to anaesthesia were analysed. Mortality was included as a critical event in our study and analysed.
Results: Critical events were documented in 50 patients (0.5%), with mortality 54%, while rest recovered completely. Highest number were documented in age group 31 to 50 years (26%) and ASA III patients(50%). Critical incidences happened more with emergency surgeries (52%), in patients with single preoperative comorbidity(35) and under general anaesthesia(78%) in maintenance phase(32.8%). Highest cause of mortality was related to cardiovascular and respiratory events.
Conclusion:  Morbidity and critical events will always be part of anaesthesia practice. They might be prevented with proper vigilance. When they happen, it should be reported without fear of punitive results. They should be studied and analysed, and proper protocols and checklists should be developed according to local guidelines and medical practices. Such studies are important part of medical education process and improve patient care.

Invasive fungal diseases (IFDs) are an increasingly common complication in critically ill patients in Europe and are frequently fatal. Because of changes in treatment strategies and the increased use of antifungal prophylaxis, the epidemiology of IFDs has changed substantially in recent years and infections due to Candida species are no longer the majority in many institutions. In contrast, the emergence of non-Candida IFDs such as aspergillosis, ucrmycosis and fusariosis has increased. Rates of IFD-related mortality in Europe depend on the pathogen, geographical location and underlying patient characteristics, with rates ranging from 28 to 59% for Candida infections and from 38 to 80% for invasive aspergillosis. Early initiation of antifungal therapy is critical for improving outcomes;