Teaching exercise of drug utilization by medical students.

The prescription is a vital written document communicating between the physician, the patient and the pharmacist. The audit of prescribing pattern is a component of medical audit, which seeks monitoring, evaluation and necessary modifications in the prescribing practices of prescribers to achieve rational and cost effective medical care for the patients, The present drug utilization study was conducted by fourth year MBBs students during their research posting in the department of Pharmacology at B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan. The prescriptions were randomly collected from BPKIHS pharmacy over a period of 3 weeks. The auditing was done in the form of a semi structured performa containing the patients particulars with regard to age, sex, and residence, the details of the illness and prescribed drug information. The data was analyzed at the end of the study. The study points out that the maximum (27.5%) prescriptions were from General Outpatient Department (GOPD) followed by ENT (16.5%), Internal medicine (15.5%) and General surgery (10%). This indicates the distribution of patient load in hospital and the dominant areas to be targeted for intervention. Further, the proportion of antimicrobial agents (AMAs) i.e. 26.03% use was low and was prescribed empirically in most of the cases. There was use of expensive AMAs and irrational prescribing of combinations of AMAs in some prescriptions. Other prevailing drugs which were prescribed were analgesics. The usage of nimesulide and rofecoxib. withdrawn by FDA were used recurrently in this setup. There was greater use of dubious drugs of unproven benefit like vitamins, calcium etc. The diagnosis of the disease were not mentioned in 32.5% of prescriptions, The dose, frequency and duration of drugs were unascertained in majority of prescriptions that might lead to health hazards. This exercise might change the behavior of existing prescribers and also of the future doctors.

Subicular lesion induced impairment in operant behaviour and altered dendritic morphology of CA1, CA3 hippocampal neurons.

The effects of bilateral electrolytic subicular lesions were examined on the operant behaviour for food reward on a continuous reinforcement schedule as well as the dendritic morphology of CA1 and CA3 hippocampal areas. The subjects were female Wistar rats 20 days of age and were divided into four groups. 1. Age matched control 2. Sham operated 3. Operant behaviour for food reward and 4. Subicular lesion. Animals were starved twenty-four hours prior to operant behaviour training sessions. Two trial sessions with continuous reinforcement (CRF) of 10 min duration/day were done during training sessions following which the rats were allowed CRF for ten minutes per day for ten days. On the eleventh day, the operant behaviour and sham operated animals were taken up for bilateral subicular lesion and sham surgery respectively. After seventy two hours of surgical recovery, operant behavioural testing was done as before for a further period of ten days. Later all the groups of animals were sacrificed and the hippocampi were processed for rapid Golgi staining technique. Our results suggest that subicular lesions do produce a significant reduction in operant learning behaviour for food reward. Further the Golgi studies revealed a reduction in dendritic branching points and intersections of apical and basal CA1, CA3 neurons in lesioned animals.