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
Background and Objectives: Offshore Caribbean medical schools (OCMS) face various challenges with regard to learning practical and prescribing skills in pharmacology. These challenges range from short curricular time, low number of faculty, problems with early clinical exposure and geographically separated clinical sites. Materials and Methods: The author highlights these challenges using his personal experience and articles from the published literature. The search terms used were pharmacology, Caribbean, medical students, prescribing skills and medical schools. Results: Among the problems mentioned are lacunae in the teaching-learning of prescribing skills, teaching pharmacology as a discipline during a particular semester, excessive focus preparing students for licensing exams, low number of faculty, shortage of time, challenges with providing early clinical exposure, problems with assessing skills, lack of integration with essential medicines and standard treatment guidelines, among others. Conclusion: There are a number of challenges in teaching pharmacology and therapeutics in OCMS. Most schools concentrate on the theoretical aspects of pharmacology which are tested during the licensing exams.
ABSTRACT
Theatre of the Oppressed (TO) created by the Brazilian theatre personality, Augusto Boal helps individuals deal with both external and internal sources of oppression. TO workshops are now held in many educational institutions and other settings. TO enables participants to step beyond the walls of the classroom, explore various life situations, improves the skill of both verbal and non-verbal communication, enables participants to experience various oppressors and oppressed situations and formulate strategies to deal with them. The authors describe a three day TO workshop conducted at KIST Medical College, Lalitpur, Nepal from 6th to 8th April 2012.
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.