Seasonal Variation in an Outpatient Antibiotic Prescription Rates in Alkharj

Aim:The aim of this study was to describe the seasonal variations in dispensing antibiotic prescriptions in the outpatient setting of a public hospital in Alkharj.Methodology: A retrospective cross-sectional study was conducted. The outpatient prescriptions in 2017 and 2018 were collected from medical records in a public hospital in Alkharj. The data include the number of prescribed antibiotics in general, the number of prescribed antibiotics in different months and seasons in the outpatient setting.Results: In the outpatient setting in 2017 and 2018, antibiotics were prescribed excessively in most of the months. About 27.84%of the prescriptions in 2017 were in spring season and about 26.64%of the prescriptions in 2018 were in autumn. Total number of antibiotics prescriptions in 2017 and 2018 were 5348 in spring followed by 5097 in autumn.Conclusion:The results of the present study showed the widespread use of antibiotics bypractitioners that was associated with season of prescribing. In general, there are excess use of antibiotics in all months. It is important to understand how the prescribing of antibiotic varies throughout the year to design an appropriate intervention to decrease incorrect antibiotic use

Cross-Sectional Study of Impact of Social Support on Depression among Type 2 Diabetics in a Secondary Health Care Facility in Southwest Nigeria

Aims: To assess the level of social support and determine the relationship between depression and social support amongpatients with type 2 diabetes mellitus (DM).Study Design:This study was a cross-sectional survey.Place and duration of Study:The study was carried out at the Medical OutPatients(MOP) clinic of Jericho Specialist Hospital, Ibadan between 1stof August and 30thof September 2017.Methodology:Systematic sampling technique was used to recruit 273 type 2DM patients who were 40years and above, receiving care at the MOP clinic for at least 3months. Diabetes-related information was collected using a semi-structured questionnaire. Zung self-rating scale and multidimensional perceived social support scale were used to assess depression and social support respectively. Independent t-test was used to determine the relationship between depression and social support and the level of significance was set at p<.05 Results:Half (50.5%) of the respondents were diagnosed in the past 5 years as having type 2DM, 79.5% had hypertension as a co-morbidity and 51.6% had good glycaemic control. The prevalence of depression was 27.5%, mild and moderate depression were 26.4% and 1.1% respectively and none had severe depression. One hundred and two (37.4%),56.0% and 6.6% respondents had high, moderate and low social support respectively. The highest social support scores 5.9 +1.7 was from family. Total perceived social support was higher among non-depressed diabetic respondents. There was a significant difference between the mean total support in the depressed and non-depressed group (4.88 ± 1.41 vs 4.50 ± 1.24, p= .03).Conclusion:Type 2 DM patients who had high social support were less depressed, therefore, clinicians managing DM patients should explore the social support enjoyed by such patients to achieve good health outcome

To Find Out Psychiatric Morbidity in Dermatological Outpatient

Background: Psychiatric problems  in skin outpatient department are very common. This study evaluates various psychiatric manifestation in skin out patients and its impact on day to day living of patients. About 40% of skin out door patients had a minor psychiatric problem e.g. Depression, Anxiety, Adjustment disorder etc. Patients with psychiatric problems were more psychosocial problems like less socialization, avoidance, job and marital problems etc. Methods: This study was conducted at dermatology outpatient department at civil hospital Ahmadabad. 200 consecutive dermatology out patients above age 15 were studied. All patients were requested to fill in general health questionnaire Guajarati version. Patient has to tick mark one out of the four alternative response. Those who could not read, interviewer read out the questionnaire and recorded the patient’s responses. Results: Sleep disturbance was present in 83% of patients. More than quarter of patients reported marital problem after onset of skin lesion. Avoiding people, stopped going out, more time in grooming and stopped hobbies were less common. Work loss and job impairment were present in 16% and 8.5% patients respectively. Conclusion: Out of 200 dermatology out patients 81 (40.5%) had psychiatric morbidity on clinical interview. Adjustment disorder, depression, anxiety disorders were most common diagnosis. Psychotic disorders were found was found in 3 patients.  Patients with psychiatric morbidity were older than patients without psychiatric morbidity.

Prescribing patterns of antimicrobial usage in ophthalmology out patients department at tertiary care teaching hospital.

Background: Drug utilization provides prescribing behaviors of prescriber. Rational prescribing of antimicrobial drugs plays a crucial role in reducing the antibiotic resistance. The study aim was to analyze the patterns of antimicrobial prescribed ophthalmology outpatient department (OPD) patients. Methods: The study was an observational study completed over a period of 6 months, from July 2014 to December 2014. The study was conducted in Department of Ophthalmology, MGM Medical College, and Hospital Navi Mumbai. A questionnaire was specifi cally designed factoring patients’ demographical profi le, diagnosis of disease, drug regimen. Results: A total 125 prescriptions of patients were analyzed who visited ophthalmology OPD department. Maximum patients belonged to the age group of 41-50 years (27.2%), followed by age group of 31-40 years (25.6%). The proportion of male (59%) patients was more as compared to female patients (41%). Total drug prescribed was 296. Average drug per prescription was 2.36. Among 296 drugs, 144 were antibiotic prescribed. Average antibiotic per prescription was 1.15. Most commonly antibiotic prescribed was moxifloxacin. Most common fixed dose combination (FDC) of antibiotic prescribed was tobramycin plus loteprednol. Among total 125 patients, maximum patients were diagnosed with cataract (25%), followed by meibomitis (12%), conjunctivitis (24%), blephritis (9%), foreign body in eye (12%), psedophakia (10%) and other disease (8%). 96% of antimicrobial were prescribed from essential drug list. The FDC of antimicrobial (40%), fl uroquinolone (19%), aminoglycoside (13%), broad spectrum (12%), macrolide (9%), anti-viral (7%) was prescribed. Maximum number of drugs was found in the form eye drops (72%). Conclusion: The present study found that FDC of antibiotic was prescribed maximum. Most common dosage form of prescribed drug was eye drop. Prescription of drugs by brand name was a matter of concern

The Application and Effectiveness Evaluation of Continuing Care Based on Humanistic Care for Out Patients with Facial Plastic Surgery / 中国医学伦理学

Objective:To evaluate the effect of continuing care in facial plastic operation .Method:Select 120 patients who had aesthetic plastic surgery in our hospital during the period from January to July in 2014 and ran-domize them into the observation group (60 cases)and the control group (60 cases).The control group merely re-ceive conventional treatment .The observation group is employed continuing care based on conventional treatment . Results:The satisfaction of two groups has no significant difference a week after operation (P>0.05).Six months after operation , the satisfaction of the observation group is obviously higher than that of the control group .The difference is statistically different ( P<0 .0001 ) .The anxiety level of the observation group is obvious lower than that of the control group and the difference is Statisticallydifferent ( P<0 .0001 ) .Conclusion: Based on the hu-manistic care, carry on the continuing care could considerately improve the satisfaction of patients in clinic facial plastic surgery and is one of the most important solution of preventing medical disputes ;mean while , it is also one of the most effective stress reduction measures which makes the patients feel humanized nursing .

The practice of the effect of quality control circle in medicine waiting time reduc-tion of out-patients in Hospital of Traditional Chinese Medicine of Foshan City / 药学实践杂志

Objective To investigate the effect of quality control circle in the reduction of medicine waiting time for out‐patients .Methods Analyze the reason of the increase of medicine waiting time for out‐patients was analyzed .Specific plan was made and carried out .Medicine waiting time for out‐patients before and after the intervention was compared by statistic analy‐sis ,and the effect of quality control circle was assessed .Results The average medicine waiting time for out‐patients after inter‐vention was 14 .47 min ,which was 2 .45 min shorter than the average time before the intervention;67 .78% of the patients got their medicine within 15 min after the intervention ,which was 10 .61% higher than that of before the intervention ;the quality control methods ,abilities of solving problems and working initiative of the quality control circle stuffwere improved .Conclusion Quality control circle is capable of increasing dispensing efficiency ,shortening medicine waiting time for out‐patients ,and promoting the core competitiveness of dispensary of traditional Chinese medicine .

Effect of hospitalization on rest-activity rhythm and quality of life of cancer patients.

Rest-activity rhythm and quality of life (QoL) in three cohorts, namely (1) cancer in-patients, (2) out-patients, and (3) control subjects were studied. The patients of the former two groups were chosen randomly from the Regional Cancer Center, Raipur, India. All patients received chemotherapy for 3-4 consecutive days. The in-patients remained hospitalized for the entire period of chemotherapy plus one day post treatment. The out-patients, unlike the in-patients, went to their homes daily after treatment. Rest-activity rhythm of the patients was monitored using Actical. Quality of life (QoL) and psychological status of patients were assessed using EORTC QLQ-C30 and Hospital Anxiety & Depression Scale, respectively. Each subject exhibited significant circadian rhythm in rest-activity. The average values for Mesor, amplitude, peak activity, autocorrelation coefficient and dichotomy index of all three groups varied significantly between one group to the other in the following order: in-patient < out-patient < control. Further, quality of life, measured from responses on functional and symptom scales, was better off in cancer out-patients compared to the in-patients. It is concluded that hospitalization alters rest-activity rhythm parameters markedly and deteriorates QoL in cancer patients. Nevertheless, further extensive investigation is desirable to support the above speculation and to ascertain if hospitalization produces similar effects on patients suffering from diseases other than cancer.

Why do patients come to the Accident and Emergency Department, RIPAS Hospital?

Introduction The total number of patients, especially the non-urgent cases (Priority 3) attending the Accident and Emergency Department (AED) of the RIPAS Hospital have increased from 1996 to 2003. This questionnaire study looked at the reasons for attending the AED of RIPAS Hospital instead of the outpatient peripheral clinics or health centres. Materials and Methods The study was conducted using prepared survey questions (17 questions) from 15th May to 15th June 2004 (32 days) on patients/care-givers/accompanying persons (Priority 3 - non-urgent/not serious cases) who attended the AED for various reasons. A total of 398 respondents participated in the study. Results Most of the respondenta were Bruneian (88.9%) with the rest consisting of permanent residents 4.6% and expatriates (7.2%). The majority of respondents were in the age group between 16 to 45 years (32.8%). Reasons for going the AED RIPAS hospital included complete facilities (Radiology, Laboratory and etc, 87.7%), provision of a 24 hours service (89.8%), patients' perception of their illnesses being serious (81.9%), more comprehensive check-ups (66%) and less traffic leading to the AED at certain times of the day (61.2%). Interestingly, some were unaware of available specified health services in their area and that extended services were available in Ong Sum Ping Health Centre. Conclusion A majority of responders attended the AED for various reasons. Patient education is important to increase awareness so that priority 3 cases can be directed to peripheral clinics to reduce congestions at the AED RIPAS Hospital.

Investigation and analysis on anti-infective administration in out-patients of our hospital / 中国基层医药

Objective To investigate the use of anti-infective drugs in outpatients of our hospital, and to pro-mote rational administration in clinic. Methods Collecting the prescriptions of out-patient during June 2007 in our pharmscy,then statistically analyze the anti-infective drugs information in combination with adverse drug reaction (ADR) reports. Results The percentage of prescriptions was 45. 8%, the average amount of the prescriptions was 62. 56 yuan,the cost of anti-infective drugs accounted for 41.8% ,prescriptions of combined use and injection were 39.5% and 37.2% ,the ratio of ADR was 80. 6% ,irrational administration accounted for 10. 8%. Conclusion The use of anti-infective drugs in our prescriptions of out-patients has some problems, but rational use is the main trend in our hospital.

Analysis on 494 ADR Cases of Out-patients in Our Hospital / 中国药房

OBJECTIVE: To investigate the characteristics and regularity of adverse drug reactions (ADR) of out- patients occurred in our hospital. METHODS: 494 cases of ADR cases collected in our out- patient dispensary from 2007 to 2008 were analyzed retrospectively. RESULTS: Of total 494 ADR cases,ADR incidence of female (62.96%) was obviously higher than male (37.04%). 58.50% of ADR cases were induced via intravenouse route drugs and 51.21% were caused by antibiotics,among which 104 cases were caused by fluoroquinolones and 90 cases by macrolide,followed by the cardiovascular and cerebral system drugs (13.97%) and traditional Chinese medicine (13.16%). The main clinical manifestations of ADR cases were lesion of skin and appendant (29.17%),injury of digestive system(22.37%) and nervous system(17.34%). CONCLUSION: More attention should be paid to the ADR monitoring to provide reference for clinical rational use of drug.

The Level of Awareness concerning Kampo among Out-patients / 日本東洋医学雑誌

We sent out questionnaires to out-patients that were receiving treatment at our Kampo clinic to determine their level of awareness concerning Kampo medicine.<br>The patients were particularly concerned about side effects, and the most frequent reason given for choosing Kampo was that it had few side effects. Although most felt that there were almost no side effects associated with Kampo, there were some that thought Kampo had absolutely no side effects, or that it could cause serious side effects. These responses indicate the need to explain any potential side effects fully to patients. Also among the responses were criticisms of Western medicine, people who reported that Western medicine had not helped them and those that felt they could not rely on Western medicine.<br>The expectations in Kampo for disease treatment were high, and the effectivectiveness of treatment was also highly rated. Moreover, there were expectations in other aspects of Kampo medicine that cannot be found in Western medicine, such as improvement of the constitution, health maintenance, disease prevention and increased stamina. The responses indicated that patients seeking treatment by Kampo were not satisfied with Western medicine, and were looking for a treatment method they could rely on in Kampo medicine.

Breast feeding: The survey in paediatric out-patients.

Two thousand and seventeen guestionnaires were collected from 4 regional university hospitals in Bangkok (Siriraj), Chiengmai, Khon Kaen and Songkhla during November-December 1987. No difference was found in the proportion of the babies who were breast fed (at least for 1 month after birth) and those who were bottle fed among these hospitals. Although almost 80 percent of those babies were breast fed, the figure was lower than that in the community survey, 94 percent in 1984.

Social service for the paediatric out patients.

The medical social service to the paediatric patients referred by doctors from out patient department, Siriraj Hospital, between 1984-1987 were analyzed. The total number of services were 54,276 in 18,127 paediatric patients or 18.4 percent of total 98,641 out paediatric patients. The age, sex, domiciliary origin, profession of parents, type of services were demonstrated in 8 tables. Detail and problems of social service were discussed.

Statistical Observation on Outpatients, Inpatients and Operations in Department of Urology, Capital Army Hospital, Seoul, Korea (1962-1963) / 대한비뇨기과학회지

Clinical and statistical observation was made on outpatient inpatients and operations in Urology Department of the Capital Army Hospital during the period from Jan., 1962 to Dec. 1963 and the results (1) Clinical statistics on outpatients. 1) Total outpatient were 2213 cases, 2179 males and U females, and the male to female ratio was 64.1:1. 2) The number of outpatient increased in winter and decreased in summer. 3) According to age distribution, the majority of the patients (96.2%) where between 21 and 40 years of age. 4) The most common diseases were urethritis (35.7%) showing annual increase, while redundant prepuce, urolithiasis, injury of genito-urinary tract, nonspecific epididymitis and hydrocele, showing annual decrease. 5) Renal tuberculosis showed annual decrease and tuberculous epididymitis, annual increase. (II) Clinical statistics on inpatients. 1) The inpatients during 2 years were 241 cases which comprised10.9% of total outpatients. The male inpatients stood for 11% of total outpatient and the female inpatients, 5.9%. 2) The most common disease were renal tuberculosis, hydrocele, non-specific epididymitis, stones of kidney and ureter, tuberculous epididymitis, urethral rupture and scrotal hematoma. (III) Clinical statistics on operations. The number of total operations were 640 during 2 years. Circumcision comprised 34.0% of total operations, vasectomy, 30.6% Nephrectomy, 6.1% ; epididymectomy, 6.1%, hydrocelectomy, 4.1% and plastic surgery of urethra, 2.3%. One case of Bricker's operation was performed.