ABSTRACT
Background: Presently drug utilization studies (DUS) are in an evolving era. Current literature search has shown paucity of epidemiological studies in the field of paediatric pharmacology. Hence the present study was designed to assess the drug utilization pattern in neonatal intensive care unit to improvise the current prescription practices, if required and to determine areas in neonatal pharmacology in need of further research.Methods: A prospective, observational study spanned for a period of one year from January 2015 to December 2015 was conducted at the neonatal intensive care unit (NICU), Government teaching tertiary care hospital, Maharashtra. Data of prescribed drugs was collected. WHO prescribing indicators were used for evaluating DUS. Assessment of exposure rates of different class of drugs in different gestational age groups was done. Data were analysed using descriptive studies.Results: Data of 205 neonates, showed male preponderance (53.17%) over female neonates (46.83%). With regard to the gestational age, 47.31% were term, 52.68% preterm. Average number of drugs per encounter was 6.69. 76.29% drugs were prescribed by generic name and 69.80 % drugs were from IAP list of essential medicines for children. Mean drug use was 6.23�34 per patient. Most common class of drug to which neonates were exposed was antibiotics (96.10%) and amikacin topped the list with exposure rate of 91.22%.Conclusions: The present study substantiates the need for implementation of institutional antibiotic policies, awareness regarding IAP list of essential drugs for children, prescription by generic name and rational drug use.
ABSTRACT
Background: Adequate disinfection and sterilization is crucial to prevent hospital acquired infections, this requires knowledge of various types of disinfectants and of the categories of medical and surgical devices. Nurses play a key role in supervising the use of disinfectants. Hence, they are an important target group for educational interventions for rationalization of disinfectant use. We conducted an educational intervention in nurses, related to rational use of disinfectants. The objective was to evaluate the immediate impact of this intervention on change in knowledge of nurses. Methods: This was a questionnaire based pre and post test cross sectional study. The questions were formulated to test nurses’ ability to (1) categorize commonly used medical and surgical devices (MSDs) (2) categorize disinfectants as high, intermediate and low level disinfectants (3) to evaluate their knowledge about different aspects of disinfectant use. Results of pre and post test were calculated as a percentage and Z test for difference between proportions was applied to test the statistical significance. Results: A total of 72 nurses filled the pre test and 70 the post test. Percentage of correct responders for classification of MSDs improved as follows critical (77.77% pre test to 95.71% post test), semicritical (18.05 54.28%), noncritical (41.66 72.85%). Percentage of correct responders for classification of disinfectants improved from pre to post test glutaraldehyde (48.61 88.57%), Hydrogen peroxide (30.55 72.85%), benzalkonium (33.33 58.57%). Identification of chlorine concentration required for cleaning floors improved from 38.88% to 70%. There was a significant improvement seen post test to items related to different aspects of disinfectant use. Conclusion: A positive immediate impact was observed, but there is a need for continuing education with interventions focused on various aspects of disinfectant use.
ABSTRACT
Background: Leptin, a hormone secreted by adipose tissues, controls body weight through regulation of appetite and thermogenesis. The present study was aimed to observe role of leptin in healthy and polycystic ovary syndrome (PCOS) women. Methods: Correlation between serum leptin and anthropometric, endocrine and metabolic profile was studied in 30 apparently healthy women (control group) and 38 PCOS women (PCOS group). Each group was stratified based on body mass Index (BMI), as normal weight (BMI<23) and overweight/obese (BMI>23). Results Leptin level was high in 30% control group and in 65.79% PCOS group. Mean leptin (ng/ml) in PCOS group was higher compared to control group (18±1.9 v/s 12±1.7, p<0.05). Mean leptin levels were higher in overweight/obese subgroup as compared to normal weight subgroup in both Control (p<0.05) and PCOS groups (p=<0.05). In control group, leptin showed positive correlation with waist circumference (WC) (r=-0.49, p<0.01) and negative correlation with Cholesterol: HDL ratio (p<0.05). In PCOS group, leptin showed positive correlation with BMI (r=0.377,p<0.05) and Triglyceride (r=0.34,<0.05) and negative correlation with Fasting Blood Glucose( FBG)(r=-0.33,p<0.05). In normal weight subgroup among control group (n=25), leptin showed positive correlation with LDL (r=0.49, p<0.05). In control overweight/obese subgroup (n=5), leptin showed positive correlation with Follicle Stimulating Hormone (FSH) (r=+1.0, p<0.05) and inverse correlation with testosterone(r=-1.0,p<0.05). In normal weight subgroup among PCOS group, leptin had a positive correlation with LDL: HDL ratio (r=0.488, p<0.05). Conclusions: Hyperleptinemia is common in obesity. Leptin controls glycemic status in patients with IR. Correlation of leptin with FSH and testosterone is influenced by obesity and PCOS. Leptin regulation of lipid homeostasis is influenced by obesity or PCOS.
ABSTRACT
Background: Drug utilization studies are used to analyze different aspects of the use of drugs and to implement methods of improving therapeutic quality. This study was conducted to study drug prescription pattern in outpatient department of Government Medical College and C.P.R. Hospital, Kolhapur which is one of the important medical college in western Maharashtra. Methods: One thousand prescriptions were screened & analyzed as per the study parameters from OPD of Government Medical College & C.P.R. Hospital, Kolhapur. Study parameters like demographic profile of the patient like age, sex and diagnosis were recorded. Also groups of drugs commonly prescribed, number of drugs per patient, drug profile and drawbacks of prescription if any were recorded and analyzed. Results: Most common group of drugs prescribed by physicians was Analgesics (32.83%), followed by Antimicrobials (22.82%), Multivitamins (16.42%) and Antacids (9.14%). The average number of drugs prescribed per patient was four; the average number of analgesic was one. The incidence of polypharmacy was common occurrence and some prescriptions had small drawbacks like absence of diagnosis, absence of doctor’s signature, etc. Conclusions: We conclude that most of the prescriptions which were analyzed at R.C.S.M. Government Medical College and C.P.R. Hospital, Kolhapur, were according to the standard norms of WHO prescriptions and also most of the drugs prescribed were from the list of essential drug list. But still there is scope for improvement in prescription pattern.