Quality of Antibiotics Prescribed in Selected Outpatients Healthcare Facilities in Papua New Guinea

@#The study was conducted to evaluate compliance of antibiotics prescribing in three selected outpatients healthcare facilities in Papua New Guinea(PNG), to the country specific Standard Treatment Guidelines(STG)and to identify factors influencing prescribing pattern. The study was carried out in the Losuia Health Centre (LHC), Alotau Provincial Hospital and Port Moresby General Hospital (PMGH) outpatient departments. The study sample involved300participants at each setting. Oral amoxicillin products, chloramphenicol and co-trimoxazole made up approximately 70% of the antibiotics prescribed to 637/1090 of patients. Almost one-quarter (24.4%) of prescriptions for antibiotics were non-compliant selections. At the LHC approximately 20% of both dosage and duration errors occurred. Overall non-compliant prescribing for children was approximately 50% but significantly more compliant at PMGH (P= 0.0058) contrasting with the other settings. At the LHC only 30.6% of antibiotic prescriptions for children were compliant with STG requirements and fulfilled PNG regulatory requirements. With respect to the STGs, Community Health Workers (68.0%) and Nurse Officers made more non-compliant antibiotic selections. High levels of antibiotic prescribing combined with high levels of non-compliant antibiotic prescribing as compared to PNG-STGs, were identified in this study. This is a disturbing finding as it raises many questions related to quality assurance of health care interventions in PNG. The data also raises a clinical concern for the high level of oral chloramphenicol prescribed in out-patient settings.

Structure, control and regulation of the formal market for medicinal plants' products in Nigeria

Abstract: There are informal and formal markets for medicinal plants' products in Nigeria. The formal market is subject to the national regulatory framework for Food and Drug Administration and Control. It is relatively new and underdeveloped. This study was designed to appraise this market with special emphasis on the market participants, market structure, marketing functions performed, conduct of sellers in the market and; standards and regulations to which the market is subject. Information used for this study was collected through personal interviews and interactions with key participants in the market; especially the officials of regulatory agency. The market structure was analysed in terms of the share of market controlled by participants and product types. Concentration Ratios (CR2 and CR4) were used to assess the market share. Marketing functions being performed were described in terms of the exchange, physical and facilitating functions while the conduct was described in terms of pricing and promotional strategies. The regulatory framework under which the market operates was appraised. The market was highly concentrated with a CR2 and CR4 of 58.5% and 80.8 %; respectively. Imported products accounted for only 12.3% of the market. The predominant modes of presentation of the product were capsule (41.6%) and liquid (36.2%). About 20.77% of the products were classified as multivitamins, 13.85% were antibiotics while 10.77% addressed sexual dysfunctional problems. These products were regulated under the Food and Drug Administration and Control (NAFDAC) decrees, 1993-1999. Only 2.3% of the products have received full registration status while the others were only listed

An effective integrated learning programme in the first year of the medical course.

BACKGROUND: An integrated approach to teaching medical subjects is an effective educational strategy. Yet, this has not become popular in medical colleges in India. We describe an integrated learning programme to teach the gastrointestinal system in the first year of the medical course. METHODS: The integrated learning programme was conducted for 3 years (2003-2005). It incorporated elements of problem-based learning, early clinical exposure, lectures and small group laboratory work. Student assessment was formative (for problem-based learning sessions) and summative (using problem-based learning and knowledge tests). Evaluation of the programme was based on feedback from the students and faculty members. RESULTS: Ninety-six per cent of the students obtained more than 60% marks in the problem-based learning test. The mean (SD) score in the knowledge test was 62 (0.89)%. The majority of students received satisfactory and more than satisfactory grades for their performance in the problem-based learning sessions. The feedback from faculty members and students was positive, which highlighted benefits such as integrated learning of the basic sciences, their application to clinical cases and active student learning. The challenges encountered included the higher input required from faculty members. Most of the faculty members and students recommended that the integrated programme should be continued and extended to other parts of the curriculum. CONCLUSION: An integrated learning programme is feasible within a conventional medical curriculum of an Indian medical college.

Gross left ventricular voltage with preexcitation in isolated left ventricular non-compaction.

A 30 years man presented with symptoms of heart failure with prior history of pulmonary tuberculosis, on routine investigation he was found to have gross left ventricular voltage on the electrocardiogram and evidence of ventricular pre-excitation. His echocardiogram confirmed the diagnosis of left ventricular non-compaction. The aetiopathogenesis, clinical features, diagnostic criteria and review of literature of this rare entity is discussed here.