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Objective: To estimate the prevalence of Chronic renal failure (CRF) in the Indian subcontinent and to identify risk factors and treatment regimens for CRF. Methods: A prospective observational study was carried out for 7 months. A total of 200 patients with a level of creatinine >1.5 mg/dl were enrolled. CRF prevalence was measured using the hospital’s inpatient department registry and medical records. The risk factors and prescribing were evaluated from the patient file report. Results: The prevalence rate of CRF was 13.7%. Male patients (59%) dominate the entire group of patients. Most patients (n = 52) were found between the age group of 71–80 years with a mean age of 62.67 ± 16.33 years. Drugs such as diuretics, and hypoglycemics were indicated to treat comorbidities. The average number of drugs per prescription were 7.43 ± 2.75 with high use of antimicrobial agents (88%). Out of 156 drugs prescribed, 76 were from essential as per essential Drug List 2017. Hypertension (P = 0.0072) and diabetes (P = 0.0084) were major concerns as risk factors followed by the drugs used for dyslipidemia, and recurrent infections. Conclusion: The prevalence rate was found to be 13.7% with significant association with risk factors such as hypertension, diabetes, and nonsteroidal anti-inflammatory drugs, dyslipidemia, chronic infections, smoking, and renal calculus for CRF. The pattern of prescribing was suitable and with few irrationalities.
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INTRODUCTION Visual acuity assessment is a simple but extremely important examination in ophthalmology. This aids examination and diagnosis of common eye diseases. This is done using standardized Snellen’s chart1.OBJECTIVE To teach visual acuity assessment to undergraduates by various Teaching-learning methods,Obtaining perception of faculties and students for these.,To identify the method most preferred by most of the undergraduates.METHODOLOGYA prospective experimental study.Sample size = 100After IRB approval, the study was carried out during the ophthalmic term of third MBBS students. Four teaching methods were power point presentation, role play, video clip show and clinical demonstration. Evaluation was done by pre-post test in form of standardized validated MCQs (cognitive domain) and DOPS (directly observed practical skill) with checklist (for psychomotor and affective domain).RESULTS Statistically significant improvement in learning of students observed from pre-post test. Mean value of marks improved from 5.64 to 8.94 and SD value 1.307 to 1.052 with p value 0.0001 .Student’s feedback was suggestive of increase in confidence in skill with preferred method being clinical demonstration. Faculty feedback was positive with suggestion for such modules for other topics as well.CONCLUSION Learning improved with multiple teaching-learning methods. More than 95% faculty and students agree with the teaching-learning methods.LIMITATIONLong term results could not be evaluated.
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Background: Prescribing quality is a matter of major concern worldwide. This study was carried out to determine the quality of prescribing in chronic diseases at primary health care (PHC) and secondary health care (SHC) settings using the new prescription quality index (PQI) tool. Methods: A cross-sectional observational study was carried out at four PHC and two SHC facilities in Anand district of India. Patients attending these facilities for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor (score of ≤31), medium (score 32-33), and high quality (score 34-43) based on PQI total score. The internal consistency of PQI was measured using item total correlation and Cronbach’s α so as to validate it in our settings. Data were analyzed using Statistical Package for Social Science 20. Results: A total of 134 prescriptions were collected and evaluated for quality of prescribing. Mean age of patients was 60.6 ± 13.5 years. Mean PQI score was 23.60 ± 9.3 with 71.6% prescriptions being of poor quality. Quality of prescribing did not differ at PHC and SHC (P>0.05). Of 22 criteria, PQI score was strongly correlated with drug indication, drug effectiveness, evidence-based prescribing, unnecessary duplication, duration of therapy, and cost (P<0.01). PQI total score was negatively correlated to the number of drugs per prescription. Cronbach’s α for the entire 22 criteria were 0.90. Conclusion: PQI was found to be a reliable tool for assessment of prescribing quality in chronic diseases.