Comparative study of patient-based versus case-based teaching in prescription writing skills of second year MBBS students

Background: Prescription writing errors can lead to deficiencies in healthcare. Although prescription writing is a part of the medical students' curriculum with traditional methods, their prescribing skills are still poor due to inadequate training. To fulfil the need for new educational interventions this study aims to compare patient-based teaching with case-based teaching in improving prescription writing skills of second year MBBS students.Methods: This prospective comparative study was carried out after orientation of participants to prescription writing as per WHO prescribing guidelines (n=71). Group A (n=37) and group B (n=34) were given patient-based teaching and case-based teaching respectively of prescription writing for the same five common clinical conditions. The prescription writing skill was assessed by evaluating the prescriptions written by both the groups and scored by 19-point scoring system. Feedback from the group A students was also taken.Results: Statistical analysis of mean scores of group A (15.90) and group B (13.14) was done by Mann-Whitney U test (p<0.001). Comparison of both the groups for the individual parameters was done by Chi-square test which found significant difference in writing some important parameters like doctor’s registration no., contacts of prescriber, name of the medicine, strength of drug, dosage form, dosing instructions, total quantity of medicine and duration of medication etc. Group A students’ feedback brought out the fact that patient-based teaching is a good tool for teaching and learning.Conclusions: Patient-based teaching for prescription writing improves students’ prescription writing skills in an effective way in comparison with traditional case-based teaching.

In Vitro Comparison Of Generic And Branded Formulations Of Ceftazidime Using Standard Strain Of Pseudomonas.

Background& Objective: Use of generic medicines has been increasing in recent years as a cost saving measure in health care provision. But, there is an uncertainty about whether the quality of a generic medicine is equal to, greater than or less than its equivalent brand-name drug. Its quality must be evaluated in vitro and in vivo in order to confirm their suitability for therapeutic use. Here, we have done in vitro comparison of generic and brand formulation of ceftazidime against pseudomonas standard strain (ATCC 27853). Methodology: One generic and three brands of ceftazidime were selected for in vitro comparison. Microbiological assays were used to establish the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) against pseudomonas standard strain (ATCC 27853) according CLSI (Clinical Laboratory Standard Institutes) guidelines. Results: The MIC values of the ceftazidime samples evaluated (Brand and generics) were the same for pseudomonas standard strain tested, indicating that all products behaved similarly. The MBC values were very similar for all samples. Overall, therefore, the results showed no significant differences among samples. Conclusion: Reference method MIC and MBC testing of ceftazidime against pseudomonas has demonstrated no significant difference in in vitro activity between generic and brand products.

Assessment of efficacy and safety of artesunate plus sulfadoxine pyrimethamine combination for treatment of uncomplicated falciparum malaria.

Background: Resistance of Plasmodium falciparum to antimalarial drugs is common in India. World Health Organization (WHO) recommends artemisinin based combination therapy (ACT) to counter the development of resistance in P. falciparum. WHO recommends that ideally antimalarial drug treatment policy or guidelines should be reviewed regularly and updated at least once every 24 months. In consideration to the above recommendation, we planned to conduct the following study. The objective was to determine the efficacy and safety of artesunate + sulphadoxine pyrimethamine (AS + SP) in patients with uncomplicated P. falciparum malaria. Methods: The study included 60 patients of uncomplicated P. falciparum. Each patient received AS + SP as per WHO guidelines. Diagnosis was confirmed by peripheral blood film. All patients were followed up on days 1, 3, 14, and 28 for detailed clinical and parasitological examination. Results: Of a total 60 patients, 55 patients were followed up for 28 days. Remaining 5 patients were lost in follow up. As per protocol analysis, 91% (50) of patients had demonstrated adequate clinical and parasitological response. Remaining 9% (5) had treatment failure in which 5.5% (3) had late parasitological failure and 3.6% (2) had late clinical failure. In our study, mean parasite clearance time was 45.2 ± 4.2 hrs. Conclusion: AS + SP is safe and effective drug for the treatment of uncomplicated falciparum malaria. However, the efficacy of this ACT needs to be carefully monitored periodically since treatment failure can occur due to resistance.