ABSTRACT
More than half the cancer patients undergoing cancer chemotherapy develop adverse drug reactions (ADRs). Cancer chemotherapeutic agents have a lower risk-benefit ratio than other drug therapy and kill cancerous as well as the normal rapidly dividing cells including bone marrow cells, gastrointestinal epithelium, hair follicles, etc. Their main ADRs are nausea and vomiting, mucositis, constipation, diarrhea, hematological toxicities, cardiac toxicity, alopecia, gonadal toxicity pulmonary toxicity, neurotoxicity, nephrotoxicity, etc. The severity of the adverse effects may range from mild nausea to life-threatening neutropenia. Administering premedication and antidotes are very vital in these patients. Upon the occurrence of adverse effects, immediate steps should be taken to manage them. Though the ADRs due to anticancer medications are not avoidable, careful monitoring of the patients and modulating the drug schedules/dosages can help in minimizing them. Healthcare professionals should also develop strategies to minimize the occupational hazards associated with these drugs
ABSTRACT
Objectives:The aim of the study is to assess the knowledge and self-medication behavior among healthprofessionsstudents regarding antibiotic usage.Methods:A cross-sectional study was performed using a self-administrated questionnaire. A sample of 424 questionnaireswas distributed randomly among health science students of a medical university in Ajman, UAE.The questionnaire is categorized into three sections which are Socio-demographic details of the participant, knowledge and self-medication practice of antibiotic.The data was entered in MS Excel spread sheet and analyzed as per the study objectives Key Findings:Upon assessing the knowledgeof respondents,authors found85.8% of the students were familiar with the term ‘antibiotic resistance’.Half ofthe students agreedthat antibiotics treat common cold quickly.Regarding the self-medication practices,55.6% (n=236) of students reported that they always take antibioticwithout prescription. Cold and flu was the common reason for using antibiotics. Augmentin (amoxicillin and clavulanic acid) was the common medication used among the students. Nearly one third of the respondents (32.78%;n=139)saved theantibiotics in case of reinfection.Conclusions:In conclusion,antibiotic usage was common among study respondents. Preventive strategies, antibiotic stewardship programs, training, education programs and more restriction towards antibiotic dispensing should be implementedto avoid the misuse and antibiotic resistance.
ABSTRACT
Academic detailing is rarely practised in developing countries. A randomized control trial on healthcare service was conducted to evaluate the impact of academic detailing programme on the adherence of primary healthcare providers in Banke district, Nepal, to childhood diarrhoea treatment guidelines recommended by World Health Organization/United Nations Children’s Fund (WHO/UNICEF). The participants (N=209) were systematically divided into control and intervention groups. Four different academic detailing sessions on childhood diarrhoea management were given to participants in the intervention group. At baseline, 6% of the participants in the control and 8.3% in the intervention group were adhering to the treatment guidelines which significantly (p<0.05) increased among participants in the intervention (65.1%) than in the control group (16.0%) at the first follow-up. At the second follow-up, 69.7% of participants in the intervention group were adhering to the guidelines, which was significantly (p<0.05) greater than those in the control group (19.0%). Data also showed significant improvement in prescribing pattern of the participants in the intervention group compared to the control group. Therefore, academic detailing can be used for promoting adherence to treatment guidelines in developing countries, like Nepal.
ABSTRACT
Diarrhoea is one of the most common causes of mortality and morbidity in children in developing countries. Oral rehydration salts (ORS) and zinc are the primary tools used to fight diarrhoea in children. Educational outreach visits or academic detailing has been practiced over a period of time to improve prescribing behaviour in the developed countries. However, educational outreach programmes are very uncommon in Nepal. We conducted a pilot study to see the impact of educational outreach visits on the management of diarrhoea in children among 10 prescribers in the Banke district of Nepal. Initial findings suggest that there is a marked improvement on the prescribing of ORS and zinc by the prescribers after our intervention. Therefore it is planned to conduct the same study among a large number of prescribers in the Banke district of Nepal.
ABSTRACT
A 67-year-old immunocompetent male presented with intermittent fever for 3 months associated with urinary incontinence, altered bowel habits and history of loss of appetite and weight. He was treated as having enteric fever at various clinics in the city by different physicians. On evaluation the patient was found to have disseminated tuberculosis with involvement of the lungs, eyes, testes, brain, bone, kidneys, liver, spleen and possibly the gastrointestinal tract. This paper reports a case of disseminated tuberculosis to many organs with significant diagnostic delay more than twelve decades after the discovery of the tuberculosis bacillus by Robert Koch.