ABSTRACT
Background: Pharmacology is an important part of medical education. A competent doctor should be able to prescribe rational treatment to the patients to minimise the adverse effects and contribute to the improvement of overall healthcare system. There is a dire need to reform the undergraduate pharmacology curriculum to match up to the rapidly evolving medical field. Feedback system is one of the most successful instruments in improving any system. We have undertaken a similar feedback system to study the advantages and disadvantages of various study methods for teaching theory and practical exercises to the medical undergraduates.Methods: This is a cross sectional questionnaire based study conducted in the department of pharmacology. Students of MBBS 2nd year were enrolled into the study. The purpose of the study was explained to them and clarifications were made if any. The questionnaire included questions on various aspects of teaching methodology and graded by students on internationally accepted ‘Likert’ scale.Results: In our study students favoured teaching by blackboard method (96%) and many preferred a combination of blackboard and power point presentation. Discussing on issues of clinical significance of the topic was favoured by 96% of the students and 67% students responded that stressing on the facts concerned with Post graduate entrance exams is more important. Sixty nine percent and 85% students preferred short essays and MCQs respectively as method of evaluation and 68% of them favoured evaluation by both the methods. Regarding pharmacology practical exercises most of the students preferred clinical problems, dosage calculation, ADR reporting and other problem based learning techniques. Studying pharmacology as an integrated subject with other clinical subjects was preferred by 68% of the students.Conclusions: It is well known that students learn better when they are involved actively in learning process than when they are passive recipients. In our study we realised that undergraduate pharmacology teaching pattern should be modified mostly towards pharmacotherapeutics and clinical pharmacology.
ABSTRACT
Background: Pharmacovigilance is the science and activities relating to detection, monitoring, assessment, understanding and prevention of adverse effects or any other drug related problem from any pharmaceutical products. The core purpose of pharmacovigilance is to enhance patient care and generate the evidence based information on safety of medicines. The objective of present study was to evaluate the knowledge, attitude and practices of the healthcare professionals about pharmacovigilance and to assess the reasons for underreporting of ADRs.Methods: A cross-sectional study was conducted by administering KAP questionnaire to the healthcare professionals. There were 22 multiple choice questions. Ten related to knowledge, 5 related to attitude, and 6 related to practice. One question was asked to determine the reasons for underreporting of ADRs. The performance in each category was graded as good, average and poor if the number of participants giving correct/positive responses were >70%, 50-69%, <50% respectively. Question no 22 was assessed independently to find out reasons for underreporting of ADRs. Data was compiled and analyzed by descriptive statistics, Chi-square and ANOVA test.Results: The response rate in this study was 62.5%. The study included professors (11%), associate professors (6%), assistant professors (20%), postgraduates (26%) and interns (37%). That there was statistically very highly significant difference of mean score of knowledge, attitude and practice among health care professionals (P<0.001). The performance score with respect to attitude of health care professionals towards pharmacovigilance was good as compared to knowledge which was average followed by practice which showed poor performance (72.5% >51.6% >36.8%) (p <0.001).Conclusions: Awareness campaigns, CMEs, workshops on pharmacovigilance should be conducted regularly such that good knowledge about pharmacovigilance can be imparted which can be moulded into good practice.
ABSTRACT
Background: The objectives of the present study were to compare the effect of lignocaine (1.5 mg/kg IV given 3 mins before laryngoscopy and intubation), esmolol (300 μg/kg as a bolus 2 mins before intubation), and dexmedetomidine (0.5 μg/kg IV over 10 mins) on the pressor response in non-hypertensive American Society of Anesthesiologists (ASA) Grade I and II patients posted for elective surgery and the pharmacoeconomic and pharmacoepidemiological inferences drawn on comparison of these drugs. Methods: After approval by the Institutional Ethics Committee, 90 consenting adult patients aged 18-65 years of age of either sex of non-hypertensive ASA Grade I or II undergoing elective surgery under general anesthesia with endotracheal intubation were included in this randomized, prospective study protocol. (1) Group L: Patients were given IV lignocaine 1.5 mg/kg. (2) Group E: Patients were given IV esmolol 300 μg/kg. (3) Group D: Patients were given IV dexmedetomidine 0.5 μg/kg. Adequate monitoring, oxygenation, and hydration were established on the entry in the operating room (OR). All hemodynamic data were measured on arrival in OR, before induction, before intubation, and at 1, 3, 5 mins after intubation by an independent observer. Anesthesia was induced with thiopental sodium and fentanyl 2 μg/kg; intubation was performed with cuffed oral endotracheal tube of appropriate size for airway management. Surgery was allowed to start only after 5 mins of intubation. Results: Esmolol effectively blunted the blood pressure response to intubation, but incompletely attenuated the increase in heart rate (HR). Dexmedetomidine was more effective than lignocaine in minimizing the increase in HR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) subsequent to endotracheal intubation. Conclusion: Dexmedetomidine 0.5 μg/kg has manifested to maintain hemodynamic stability associated with intubation and hence may prove benefi cial for cardiac patients where the stress response to laryngoscopy and intubation is highly undesirable.