Prescribing patterns in the orthopedics outpatient department in GMC hospital, Ajman, United Arab Emirates

Information on the utilization patterns of drugs in the Orthopedics outpatient department [OPD] were lacking in Gulf Medical College Hospital [GMCH]. Hence, we aimed to investigate the prescribing patterns in the Orthopedics outpatient department [OPD] of GMCH. The study was a hospital based observational [record based] study carried out over one year period. The prescriptions of all new patients visiting the Orthopedic OPD of GMCH hospital were critically analyzed using a predetermined criterion. Prescriptions of 623 patients were randomly selected for analysis. The majority patients were South -East Asians or Arab males, aged between 26-35 years and had insurance coverage. The median number of drugs per prescription was 3 [range 5]. Low backache was the most common reason for attending the OPD. Non-steroidal anti-inflammatory drugs [NSAIDs] and muscle relaxants were the most commonly prescribed drug group. Fixed dose combinations accounted for around 17% of the prescriptions. All the drugs were prescribed by their brand names Absence of department name on the prescriptions were also observed. The prescribing pattern in the orthopedic outpatient department in GMC Hospital was generally rational. The most commonly prescribed drugs included were Nonsteroidal anti-inflammatory drugs and fixed dose combinations were observed in many of the prescription

Physical assessment simulations: a new teaching learning experience for pharm. d curriculum

The use of simulation for teaching physical assessment was introduced for the first time in pharmacy curriculum at the College of Pharmacy, Gulf Medical University, Ajman UAE. Previous reports have stated that preclinical training with patient simulation sessions may be used to enhance/ facilitate pharmaceutical care and training. To evaluate the teaching and learning outcomes of various simulation techniques used to teach physical assessment skills to Pharm. D students. A total of 42 students belonging to 3 batches of Pharm. D 8[th]semester registered for physical assessment course between 2012 1nd 2014 were provided training using various techniques for a period of 15 week. Simulation sessions like Intravenous cannulation, subcutaneous injection, and intranasal intubation, and other procedural skills were conducted using part task trainer. Full body mannequin was used to teach Basic Life Support [BLS], First aid and airway management. The training on systemic examination skills was provided using subject volunteers. The students were evaluated at regular intervals to assess their learning abilities and skills attained. Student feedback on simulation based teaching was also obtained using a structured questionnaire. Majority of students [92%] strongly agreed that quality of training provided was excellent and students were very confident in practicing physical assessment skills on a simulation based training using mannequin. The high scores obtained during feedback response indicate that mannequin models offer higher quality of training in acquiring the physical assessment skills. As an advantage of this module, instructors were able to repeat experiments and adjust teaching environment suitably at different levels of understanding of the students. This study indicates that training sessions with mannequin can serve as a better tool as compared to standardized patients to provide physical assessment training skills

Role of antibiogram in cost-effective treatment of pneumonia

High rate of mortality in pneumonia is attributed to antibiotic resistance. Rampant use of antibiotics in empirical therapy increases pathogen resistance and also increases expenditure for patients. Newer antibiotics are more expensive than older ones. Antibiogram is a chart showing, the most appropriate antibiotic to an organism. To make antibiotic therapy, effective and affordable, antibiograms specific to hospital are necessary. The primary objective of this study was to develop and antibiogram to help physicians is selecting the most sensitive and most cost-effective antibiotics against the specific pathogens of pneumonia. The sensitivity pattern of 232 pneumonia patients, admitted to Kasturba Hospital was evaluated. The cost-effectiveness of first-choice antibiotics against pneumonia pathogens was evaluated and listed in a typical antibiogram. The most common pathogens and first choice antibiotics were Klebseilla [Amikacin: n=61]; Psudomonas [Piperacillin: n=43]; E.coli [Meropenem: n=22]; Acinobacter [Cefoperazone-sulbactam: n=20]; streptococcus [Ciprofloxacin: n=19]. For Klebseilla, the alternative antibiotics suggested for the above organisms were listed based on their sensitivity pattern. Amikacin [n=61], Netilmicin [n=53], imipenem [n=51], Meropenem [n=50], Gentamycin [n=45]. Piperacillin [n=43], ceftazidime [n=40], netilmicin [n=37], gentamycin [n=36], ciprofloxacin [n=36] are recommended for Pseudomonas, cefoperazone-sulbactam [n=19], Netilmicin [n=15], Amikacin [n=15] are suggested for E. coli. Cefoperazone-sulbactam [n=20], Netilmicin [n=16], Amikacin [n=10], Co-trimoxazole [n=8], Meropenem [n=8] are recommended for Acinobacter. Ciprofloxacin [n=19], Erythromycin [n=15], Chloramphenicol [n=13], Doxycycline [n=10], Penicillin [n=10] for Streptococcus. The cost of 10 day therapy for the first line antibiotics are Amikacin: Rs. 3,750; Piperacillin; Rs.3,780, Meropenem: Rs. 60,000, Cefoperazone-sulbactam: Rs.2,306. Ciprofloxacin: Rs.252.68 for Klebseilla, Pseudomonas, Ecoli, Acinobacter and Streptococcus respectively. The cost of second line drugs Netilmicin: Rs.3,850; Imipenem: Rs.95,600; Gentamycin: Rs.29.58; Ceftazidime: Rs.21,327; Co-trimoxazole; Rs. 27; Penicillin: Rs.200.63; Erythromycin: Rs.150.80; Chloramphenicol: Rs.3,200; Doxycycline: Rs.15,40 respectively. The hospital specific antibiogram developed is beneficial to choose the best and cost effective antibiotics for pneumonia patients