Use of complementary and alternative medicines in ENT outpatient department of tertiary care hospital in Southern Rajasthan

Background: Complementary and alternative medicine (CAM) use is highly gaining popularity along with main treatment streams these days. Physicians cannot ignore this fact and should question and counsel patients about pros and cons of CAM for cure of different ailments. Aim and Objectives: The objective of the study was to know about use of CAM among patients visiting Ear, Nose, and Throat (ENT) outpatient department (OPD) in tertiary care hospital of Southern Rajasthan. Materials and Methods: An observational cross-sectional study was conducted in ENT OPD for 2 months. Two hundred and fifty patients were considered for the study. Semi-structured questionnaire was prepared and made to be filled by the patients during their visit to ENT OPD after taking informed consent. Various questions were asked like extent of use of alternative therapies, type of CAM used by the patients, patient’s knowledge about ADRs and drug interactions, reasons for which alternative medicine might have been used. Results: Among 250 patients, CAMs were used by 36 patients. The most common CAMs were either Ayurveda or Homoeopathy medicines or both. The majority of patients obtained their information from family and friends. Maximum patients used these alternative medicines for relief of cough and hoarseness of voice. Conclusion: The study throws light on use of alternative drug therapy and streams of medicine along with routine hospital treatment among patients visiting ENT OPD. This knowledge helps to understand about patients’ alternative approach to diseases, about self-medication, patient’s belief about different types of therapies and also ignorance of possible health hazards, side effects, and complications due to use of concomitant main and alternative medicines for treatment purposes.

Health-related internet usage in the Service Outpatient Department of De La Salle University Center

Background@#Health related internet usage is common among patients globally. The literature review showed no local study regarding health- related internet usage in the Philippines hence investigation of internet use for medical information in the outpatient department was done@*Objective@#To describe the health-related internet usage; its prevalence, reasons & experience on use, perceived effects and sources of medical information in the Outpatient Department of a tertiary Hospital.@*Method@#A single center, observational, sectional study utilizing a modified 33-item self- administered questionnaire about Health-related Internet usage of patients consulting at the service outpatient department of De La Salle University Medical Center, Dasmariñas City, Cavite, Philippines fromSeptember-October 2020. 381 eligible participants were included in the study based on the computed sample size. The data were reported as frequencies and percentage distribution.@*Results@#Majority of the participants belongs to the 26-35 years old group (32.02%) and most were Females (69%). Most used the Internet in general (88%) and Health-related internet usage was high among these users (78.42%). Despite the high internet usage, majority stated that the primary source of medical information was Doctors (76.25%). Commercial websites such as (Google & Yahoo) were the most commonly used during health- related searches (40.49%) and most searches were about their medical condition (36.22%). Most of the participants stated that sometimes they trust information from the internet (58.63%) and find it useful (68%). Forty five percent stated that medical information obtained from the internet were applied without consulting a doctor and subsequently, many does not disclose this information during medical consultation with a doctor (64%). Participants stated that their primary reason for Health-related internet use was personal knowledge about medical condition (57%). Also, most of the participants believed that Health-related searches do not have an effect on their medical condition (62%) and relationship with their doctor (61%).@*Conclusion@#The study clearly indicated that Health- related Internet Usage was a common practice in the outpatient department. Although, majority of the patients stated that their Doctors were the primary source of medical information, many individuals still do not divulge medical information obtained from the internet hence physicians should regularly inquire regarding health-related internet usage and educate regarding erroneous online medical information to correct misperception that may affect their health. Lastly, due to the overwhelming use of the internet among patients, health institutions and practitioners may develop mobile friendly applications to render sufficient medical service and provide holistic care to patients especially in this time of pandemic.

Development of the index system of the quality evaluation standard for pharmacist training in cough and wheeze pharmaceutical care outpatient department / 中国药房

OBJECTIVE To establish the index system of quality evaluation standard for pharmacist training in cough and wheeze pharmaceutical care （CWPC） outpatient department， and to provide a basis for the selection of CWPC pharmacist training teachers and the improvement of training plans. METHODS Based on Kirkpatrick model， using the Delphi method， a total of 15 experts from 13 tertiary hospitals in 10 provinces in China were consulted to establish the standard index system of the quality evaluation for CWPC pharmacists training. Analytic hierarchy process （AHP） was adopted to determine the weights of each indicator and quantify the index system according to the weights of indicators at all levels. RESULTS The coefficient of expert authority was 0.810， the judgment coefficient was 0.727， and the familiarity coefficient was 0.893. The Kendall coordination coefficient of each index was 0.308-0.687. The P values of χ2 test were all less than 0.05， which indicated that the degree of coordination of the experts was high. After two rounds of correspondence， Kirkpatrick model-based index system of quality evaluation standard for CWPC pharmacist training was determined. The index system included 4 first-level indexes （participants’ reaction layer， learning gain layer， behavior improvement layer， training outcome layer）， 12 second-level indexes （such as training needs， teaching methods， theoretical knowledge， practical skills， job abilities， patient benefits， etc.） and 44 third-level indexes （such as clear training objectives， core system of CWPC， special device operation and evaluation， professional knowledge related to the treatment of cough and wheeze patients， promoting the construction of CWPC， improving patient compliance）. CONCLUSIONS The constructed index system of quality evaluation standard for CWPC pharmacist training has a certain level of authority and scientificity， and provides a scientific theoretical basis for quality evaluation of CWPC pharmacist training.

Módulo Consulta externa del Sistema de información hospitalaria XAVIA HIS

La gestión de la información de salud del paciente, así como de los diferentes servicios que se brindan en los centros de atención de salud, constituyen elementos cruciales para prestar un servicio de salud de buena calidad. El Sistema de Información Hospitalaria XAVIA HIS, constituye una solución integral para la gestión médica de hospitales y centros de salud. En el módulo de Consulta externa se gestiona la información referente a la atención a pacientes ambulatorios en diferentes especialidades. El objetivo del presente trabajo es describir las principales funcionalidades y especialidades médicas incluidas en el módulo Consulta externa del sistema XAVIA HIS. El desarrollo estuvo guiado por la metodología de desarrollo Proceso Ágil Unificado. variante UCI y fueron empleadas las tecnologías, herramientas y lenguajes que forman parte de la arquitectura del sistema definida por el Centro de Informática Médica, entre las cuales se pueden mencionar: Java Enterprise Edition 6 como plataforma de programación para el desarrollo y la ejecución del sistema, como sistema gestor de base de datos se empleó PostgreSQL 10, como herramienta de modelado Visual Paradigm para UML, la notación BPMN 2.0 (Business Process Management Notation) y el Lenguaje Unificado de Modelado (UML) y el estándar HL7 CDA® (Clinical Document Architecture) para homogeneizar la arquitectura de los documentos clínicos. El desarrollo de este módulo refuerza la base de conocimientos necesaria para la toma de decisiones clínicas y administrativas, mejora el acceso a la información y la calidad de la asistencia a los pacientes.

The patient's health information management, as well as different services provided in health care centers, constitutes crucial elements to provide a good quality health service. The Hospital Information System XAVIA HIS establishes a comprehensive solution for hospitals and health centers medical management. The Outpatient module manages the information regarding outpatient care in different specialties. This paper aims to describe the main functionalities and medical specialties included in the Outpatient module of the XAVIA HIS system. The development was guided by the AUP development methodology (an UCI variant), and to achieve it, the technologies, tools and languages used are part of the system architecture defined by the CESIM and mentioned as follow: Java Enterprise Edition 6 platform as the Runtime Environment, PostgreSQL 10 as the database management system, Visual Paradigm as modeling tool for UML, the BPMN 2.0 notation (Business Process Management Notation), the Unified Modeling Language (UML) and the HL7 CDA® (Clinical Document Architecture) standard to standardize the architecture of clinical documents. This module development reinforces the knowledge base necessary for clinical and administrative decision-making, improves access to information and patients' care quality.

Drug utilization pattern in ENT outpatient department in tertiary care teaching hospital in Southern Rajasthan

Background: Drug utilization study is one of the most potent tool to promote rational drug use in medical, social, and economic scenario. Very less or no study has been done in Southern Rajasthan, hence this study shows valuable insights in Drug Utilization pattern. Aim and Objectives: To evaluate the drug utilization pattern in ear, nose and throat (ENT) outpatient department (OPD) in M.B. government hospital, Udaipur, Rajasthan. Materials and Methods: A prospective observational study was done in ENT OPD for a period of 9 months. Total 445 prescriptions were taken into consideration. All patients of the age group 18 years and above were included in the study. Results: Of total 445 cases, maximum number of patients (7.19%) suffered from bilateral chronic suppurative otitis media and minimum (2.02%) from eustachian tube block. A total number of drugs prescribed were 60. Maximum utilized drug was ibuprofen and minimum was Acyclovir. Mean number of drugs prescribed were 2.615. Maximum drugs were given by oral route and minimum as gargles. Total prescribed drugs were 1164. Most common prescribed drug group was NSAIDS (23.19%). Total cost of therapy was 58,584, cost per patient was122.6. Prescribed daily dose/defined daily dose ratio was calculated for antibiotics. Conclusion: Study shows rational drug prescribing. Account of Alternative medicine was taken in consideration, isolation of microorganisms prior drug prescribing was not done.

Queuing Dynamics and Beneficiary Satisfaction in The OPD Of a Tertiary Care Centre in Bankura, West Bengal

Context/Background: Queuing, a major problem faced by beneficiaries availing services in public health care system, may also have influence on the level of satisfaction among beneficiaries. Aims/Objectives: To describe the queuing dynamics in the OPD, to explore different factors influencing the level of satisfaction among the beneficiaries and their perception regarding possible ways to improve the queuing situation. Methodology: A hospital-based analytical study was conducted in an OPD of Bankura Sammilani Medi-cal College and Hospital, West Bengal, among 202 beneficiaries. Data were collected from subjects, se-lected from random queue in total 30 shifts (30 minutes each) on different working days, using prede-signed, pretested, questionnaire.Results: Queuing dynamics revealed utilization factor of 75%, while 25% probability of the system be-ing idle. Only 39.1% of the subjects were satisfied with the service in Paediatric OPD, in context of wait-ing in queue. MLR revealed subjects waiting in queue for a duration ≤ 1 hour and those with > 4 minutes consultation time were found to be more satisfied. Conclusions: Considering variable consultation time, arrival and service rates at the OPDs and re-sources, a well-planned system can minimize the waiting time and thus improve the level of satisfaction among the beneficiaries.

Influence of Lockdown during the COVID-19 Pandemic on Use of Pediatric Emergency Health Services: A Retrospective Observational Study from a Tertiary Care Hospital in New Delhi

January 30, 2020, marked the beginning of the COVID‑19 pandemic in India. Various emergency measures were taken to contain the spread of COVID‑19 including extended periods of complete lockdown. The impact of these measures on routine and emergency health services was unforeseen. Hence, we conducted this study to critically analyze the effects of restrictions imposed during the COVID‑19 pandemic (including lockdown) on the utilization of health services, especially emergency services. We compared patient’s attendance in the outpatient department and pediatric emergency department (PED) and changes in clinicepidemiological profiles (before and during COVID‑19) in a tertiary care hospital. We observed a 43% decline in PED visits which decreased to 75% during the period of strict lockdown (P = 0.005). Reduction in emergency department visits was noticed uniformly in all disease categories. This study highlights the urgent need to plan for robust health‑care support system for the delivery of preventive and curative services to vulnerable age groups during any emergency.

Cost analysis of outpatient department prescriptions in the community pharmacies during the coronavirus disease-2019 pandemic in Maharashtra

Introduction: Community pharmacy is a place under the direct supervision of the pharmacist where the prescription orders are compounded and dispensed. In India, there are limited studies published on the economic evaluation of community pharmacy. This study aimed to conduct a cost analysis of outpatient department prescriptions in the community pharmacies during the coronavirus disease-2019 pandemic on various parameters such as the total cost, average cost/prescriptions, age-wise cost, prescribers, drug class, pharmacy wise, route of administration, and diagnosis cost. Material and Methods: The analysis of total and average cost per prescription was conducted. The study was carried out for 6 months during. The number and type of drugs prescribed and the frequency and total cost of the prescriptions were noted. Statistical analysis was conducted for different demographics and various parameters. Results: A total of 1166 prescriptions were analyzed in the study. Out of 3704 drugs prescribed 99.9% were branded ones. The average number of drugs/prescriptions was 3.17. The predominance of male patients (60%) was seen. On the overall cost of prescriptions the statistical significance of the overall cost was established at (P < 0.00001). The sum of all the prescriptions accounted for ?.10, 86,504.65. The average cost/prescription was ?.931.82. Conclusion: The average total cost/prescription was found to be higher in our study. There is a need for further studies to be done in the field of community pharmacy

Pattern And Prevalence Of Psychiatry Morbidity Among Subjects Attended Psychiatric Outpatient Department In A Tertiary Care Hospital In Northern Telangana

Background: Mental health problem is a major public health issue all over the world including India. In India, mental disorders are the leading contributors to significant morbidity and disability amongst those affected. With changing health pa?erns among Indians, mental behavior and substance use disorders are coming to the forefront in health care delivery systems. Objec?ve: This study was aimed to assess the diagnos?c pa?ern of psychiatric morbidity among the pa?ents a?ending psychiatric outpa?ent department in a private medical college. Methodology: This cross-sec?onal study was carried out in the Department of Psychiatry in Prathima Ins?tute of Medical Sciences located at Karimnagar, Telangana, India. For this study, a total of 442 new subjects a?ending Psychiatry Outpa?ent Department (OPD) from August 2020 to July 2021 were taken. All the informa?on including longitudinal histories of pa?ents was recorded in files and the diagnosis was made following Diagnos?c and Sta?s?cal Manual of Mental Disorders-Fi?h Edi?on (DSM 5). Sociodemographic parameters and family history of mental illness were collected from the record file of the individual pa?ent. Results: In the present study, among the different age groups, the majority (28.05%) of the study subjects were of the age ranging from 21-30 years. The distribu?on according to gender was (62.89%) males and (37.10%) females. The majority of the study subjects belonged to the rural background (69.45%), educated up to 10th standard (28.73%), self-employed (29.86%), married (67.42%), belonged to Hindu religion (85.74%), and with a monthly family income of 5,000 to 10,000 (38.68%). The majority of the study subjects were diagnosed with Major depressive Disorders (28.05%), followed by anxiety disorders (17.87%) and Substance-Related and Addic?ve Disorders (16.96%). Conclusion: This study provides informa?on about the prevalence of psychiatric morbidity among pa?ents a?ending outpa?ent department in a private medical hospital in Northern Telangana. It helps in assessing the pa?ern of psychiatric problems and taking necessary steps to plan for better management of mental health care in the near future.

Practice of Promoting Rational Use of Antibiotics in Outpatient Department by Special Prescription Pre-review / 中国药房

OBJECTIVE：To provide reference for the participation of clinical pharm acists in outpatient antibiotics management so as to promote the rational use of antibiotics in outpatient department. METHODS ：The pharmacist reset medication rules ， classified irrational medication levels ，formulated warning contents ，and established a diagnosis database of mild to moderate non- complex infections ，according to the problems found in the post review of outpatient antibiotics prescription through sorting out the previous rules of antibiotics use in the Yiyao Rational Drug Use Management Software （called“review software ”for short ）in our hospital. The special pre-review was performed by using combination of system review and manual review. Pharmacists used the review saftware to count the data of outpatient antibiotics prescriptions before （the first quarter of 2020）and after （the second ， third and fourth quarters of 2020）the implementation of special pre-review. The post review for antibiotics prescriptions in Dec. 2019（before the implementation of special pre-review ）and Dec. 2020（after implementation of special pre-review ）were performed by pharmacists to evaluate the impact of the implementation of special pre-review on promoting rational use of outpatient antibitics. RESULTS：Comared with before the implementation of special pre-review in the first quarter of 2020，the prompt rate of the review software for antibiotics prescriptions was decreased ，and the interception rate was increased after the implementation of special pre-review in the second quarter of 2020（P＜0.05）. Compared with before the implementation of special pre-review in Dec. 2019，the proportion of outpatient antibiotics prescriptions in all outpatient prescriptions ，the ratio of bi-antibiotics prescriptions in all antibiotics prescriptions in the same month ，the ratio of prescriptions with unsuitable indications in all antibiotics prescriptions in the same month were all decreased E-mail：phdloveyou@163.com significantly （P＜0.01）， while the ratio of prescriptions with rational antibiotics use in all antibiotics prescriptions in the same month was increased significantly （P＜0.01）. CONCLUSIONS：Pharmacists establishing a rule for rational use of antibiotics in outpatient department b ased o n the hospital ’s situation，implementing a special pre-review for antibiotics prescriptions with the help of review software ，can promote the rational use of antibiotics in outpatient department.

Frequency of early post operative complications of modified radical mastectomy within period of four weeks

Background: Most of the complications are developed after modified radical mastectomy in breast cancer patients, hence to avoid and reduces the postoperative complications, this study is performed to identify the frequency of early post-operative complications of modified Radical Mastectomy within the period of four weeks.Methods: Cross-sectional case series using non-probability convenient sampling technique was conducted in surgical unit I of Tertiary care hospital, for 1 year from 15 January 2018 to 14 January 2019. 89 patients FNAC proved breast cancer were included, patients that received neoadjuvant chemo or radiotherapy or with inflammatory breast cancer, metastasis and with co-morbid were excluded. After taking consent patients were operated by senior consultant. Follow up was taken daily 7th post-operative day and then followed in OPD on weekly basis fourth week and final outcome was noted. SPSS version 23 was used for data analysis. Quantitative data was reported as frequency in percentages.Results: Total 31 patients developed complications during the study, accounts 34% of total patients. The most common complication was breast seroma in 12(13.48%) of cases with an increased risk in cases of age >50 yr, size of tumor >8 cm, weight >70 kg and increased number of lymph nodes [3 or above] palpable after wards hematoma in 6(6.74%), lymphedema in 5(5.62%), wound infection 4(4.49%) and shoulder dysfunction in 4(4.49%) patients, no patient was found scar hypertrophy.Conclusions: Seroma formation, hematoma were found most common early complications after modified radical mastectomy, lymphedema, wound infection and shoulder dysfunction were observed in small number of patients.

A study of timed get up and go scores as falls risk assessment in elderly in a tertiary care centre

Background: Early detection of falls risk in the community dwelling elderly helps to take preventive measures to avoid falls and hence decrease morbidity associated with falls. Falls are a serious threat to independent living and self-confidence of the elderly. Using simple tools to determine risk of falls helps in early detection and prevention of falls. Aims and objectives of the study was to establish TUG data among patients attending the geriatric clinic at MGM hospital, Kamothe and to determine risk of falls in these patients with respect to their systemic involvement.Methods: A prospective observational study of 100 geriatric age group patients were studied for their TUG scores and classified based on systems involved. TUG was performed using standard protocol and scores were stratified based on gender, age and diagnosis. Participants were required to perform TUG and were instructed to rise from an armless chair walk 3 meters and turn around at the chalk mark, walk back, and sit. They were instructed to walk at a normal pace without walking aids and shoes. Time was recorded when participants’ buttocks were lifted off the chair to stand and stopped when the buttocks touched the seat when returning to sitting position.Results: The results showed that the average TUG score of this cohort of 100 patients attending our geriatric outpatient clinic was 13 sec. 60 Males and 40 females were analyzed of which  38 patients had less than 12 s  as TUG score and 62 patients  had more than or equal to 12 sec  as TUG score. Maximum number of patients undergoing the TUG test had musculoskeletal complaints. Yet patients with respiratory conditions had the highest mean TUG score of 14 sec and patients with abdominal and CNS conditions had lowest mean TUG scores.Conclusions: This study of TUG score of cohort of 100 patients showed that average TUG score was 13 sec which was higher than  12 second mark which indicates that these patients who did not have any previous fall had a  risk of future falls and hence a requirement of  an in depth  mobility assessment and early intervention.

Rubber band ligation of hemorrhoids: a hospital based study

Background: Hemorrhoids are symptomatic anal cushions containing arteriovenous anastomosis. Patient with haemorrhoids can present as bleeding per rectum, something (mass) coming out per rectum, perianal itching, Anaemia due to occult blood loss. Various modalities of treatment have been developed to treat symptomatic haemorrhoids. This study was undertaken to determine the efficacy of rubber band ligation in the management of haemorrhoids.Methods: This study was a prospective study conducted in the Department of Surgery, Government Medical College, Srinagar from June 2015 to June 2018. Patients at any age with first, second- or third-degree internal haemorrhoids were included in the study. Patients with fourth degree, complicated haemorrhoids, previous anorectal surgery or anorectal pathology, and chronic liver disease were excluded. A total of 212 patients were included in the study. Rubber band ligation was done as an OPD procedure. The patients were followed at 2 weeks, 4 weeks, 3-month, 6 month and 1 year after the procedure.Results: In this study, out of 212 patients, 154(72.6%) were males and 58(27.4%) females. The mean age of this study was 38.7 yr. (Range 17-73 yr.). Patients presented with the complaints of bleeding (184, 86.8%), prolapse (114, 53.7%), constipation (116, 54.7%), priuritis ani (36, 17.0%), pain (12, 5.6%). Band ligation was successful in 188(88.8%) patients, 169(79.7%) patients were cured and in 19(8.9%) improvement was obtained. Various complications occurred after band ligation including vasovagal syncope (2, 0.9%), bleeding per anum (6, 2.8%), pain (12, 5.6%), fissure in ano (1, 0.5%). Recurrence after one year was seen in 9(4.2%) patients.Conclusions: Author concluded in this study that RBL is an effective outpatient treatment for grade II and III internal haemorrhoids without much complications.

A retrospective study to assess prevalence of gestational diabetes mellitus among those who delivered in Saveetha Medical College and Hospital

Background: Gestational diabetes mellitus (GDM) defined as any degree of carbohydrate intolerance with onset or first recognition during pregnancy contributes to about 90% of diabetes complicating pregnancy. GDM imposes risks for both mother and fetus, some of which continues throughout the life of mother and child. The objective of the present study was to determine the prevalence of gestational diabetes mellitus and the associated risk factors among those who delivered in Saveetha medical college and hospital.Methods: A retrospective study was conducted by analysing the medical records of the patients who were admitted in the Department of Obstetrics and Gynaecology over a period of 1 year at Saveetha medical college and hospital, Chennai, Tamil Nadu, India. The diagnosis of GDM was made mainly by 75gm one step oral glucose tolerance test (OGTT). The guideline endorses 2-hours 75-gm OGTT, irrespective of last meal timings with a cut off value of ≥140 mg/dl. All data was analysed by simple descriptive statistics and percentage method.Results: In the present study, the total number of deliveries for 1 year from April 2018 - March 2019 were 511 and among those the total number of antenatal mothers with GDM who delivered were 46. Therefore the prevalence of GDM was calculated to be 9% or 90 per thousand deliveries. In the present study, 37 (65.1%) pregnant women of GDM group were seen in the age group of above 25 years, 27 (58.59%) were multiparous, 25(54.25%) pregnant females with GDM were found to have overweight and obese out of 46 cases.Conclusions: Our current study concludes the Prevalence of GDM in Saveetha Medical College Hospital is 9% between April 2018-March 2019. We have identified the following risk factors for developing GDM: multiparity≥2; previous history of diabetes mellitus; age ≥ 25; BMI ≥25; and family history of diabetes.

Impact of Chhath festival on health seeking behaviour of local population

Background: There is lack of information regarding health seeking behaviour of local population during Chhath puja. The aim is to evaluate health seeking behaviour of local population during Chhath festival. And the main objectives is to evaluate the extent of change of routine visits of people seeking healthcare during Chhath festival across major super speciality departments of government hospital.Methods: Database of outpatient department visits across nine super specialities namely, cardiology, gastroenterology, gastrointestinal surgery, neurology, neurosurgery, nephrology, urology, paediatric surgery and oncology were obtained for year 2016, 2017 and 2018 from hospital records. Median and maximum number of outpatient visits per month of each of the nine specialities per year was compared with number of outpatient visits during Chhath festival month of corresponding year.Results: In year 2018, there was 18% average absolute decline of outpatient visit during Chhath month compared to median number of outpatient visits per month that year. Similarly, the average absolute decline of OPD visits was 32% during Chhath month compared to the month when there was maximum number of outpatient visits in 2018. Cardiology, gastroenterology, neurology, nephrology and oncology had more than 20% absolute decline in 2018 compared to median. Trends was similar in year 2017 and 2016, with average decline in Chhath month compared to median and maximum outpatient visits in corresponding year as 3%, 14%, 10% and 26% respectively.Conclusions: Health seeking behaviour of local population drops by one fifth during Chhath festival. Fall in outpatient visits is consistent, uniform and recurring every year.

Drug utilisation study in medicine outpatient department at Ashwini Rural Medical College, Kumbhari, Solapur, India

Background: Drug utilization studies are used to analyze different aspects of the use of drugs and to implement methods of improving therapeutic quality. This study was conducted to study drug prescription pattern in Medicine Outpatient Department (OPD) in Ashwini Rural Medical College, Kumbhari. Methods: Six hundred prescriptions were screened & analyzed as per the study parameters at Medicine OPD of Ashwini Rural Medical College, Kumbhari. Study parameters like demographic profile of the patient like age, sex and diagnosis were recorded. Doctor details and patient details like age, sex and address were analyzed. Also, groups of drugs commonly prescribed, number of drugs per patient, drug profile and drawbacks of prescription if any were recorded and analyzed.Results: Most common group of drugs prescribed by physicians were Analgesics (21.84%), followed by Drugs for Peptic ulcer (17.92%) and Multivitamins/multimineral (14.70%). The average number of drugs prescribed per patient was 2.38. The incidence of Polypharmacy was common occurrence and some prescriptions had small drawbacks like absence of diagnosis, absence of doctor’s signature, etc.Conclusions: Authors conclude that most of the prescriptions which were analyzed at Ashwini Rural Medical College Hospital, Kumbhari, were according to the standard norms of WHO prescriptions and also most of the drugs prescribed were from the list of essential drug list. But still there is scope for improvement in prescription pattern.

Drug Utilization Study In Geriatric Patients Visiting The Outpatient Department In Tertiary Care Rural Hospital.

Aim & Objective:The study aimed to evaluate the disease pattern, drugs used & the prescribing patterns to the geriatric patients at rural hospital.Materials and Methods: Atotal of 300 patients were enrolled in the prospective, cross sectional study. The demographic details, drugs used condition for which the drugs were prescribed and other related factors; names by which they were prescribed, use of fixed dose combinations were recorded and subjected to analysis. Observation and Results: Enrolled patients belonged to the age between 65 to 74 years, who presented with cardiovascular (21.22%) followed by musculoskeletal conditions (17.44%). Medicines were mostly prescribed by brand names 72.11%, Ranitidine was most frequently prescribed followed by Aceclofenac. About 20.35% were prescribes as FDCs for ex; Aceclofenac + Paracetamol was most commonly prescribed FDC followed by Amoxicillin + Clavulanic Acid.Conclusion: Cautious use of medicines in geriatric patients is essential which can be provided by rational prescribing.

Patient satisfaction level in outpatient department in a private dental hospital

Background: In the dental field, patient satisfaction played a very important role, specifically finding the strength and weakness in the dental clinic. It also assists in improving the quality of treatment as well as better future planning of treatment. Objective: The present study was planned and conducted with an objective to assess the level of satisfaction among patients attending the outpatient department in a private dental hospital. Materials and Methods: A prospective, cross-sectional, and questionnaire-based study was undertaken in a private dental hospital. Patients of age more than 18 years and of both gender attending outdoor patient department were included in the study. For the purpose of this survey, consecutive sampling was carried out until a sample size of 200 was achieved. The patient satisfaction was assessed using dental satisfaction survey 2002 – questionnaire. Results: Among 31 items, none of the respondents indicated strong agreement or disagreement for 30 items, only for one item, item no. 14 regarding the explanation of cost, respondents indicated strong agreement (106, 53.00%). More than 40% of respondents indicated strong agreement (indicating satisfaction) with the statement for seven items. None of the items have <10% of respondents indicated strong agreement. The respondents expressing strong disagreement (indicating dissatisfaction) with any statement was <10% on 23 of the 31 items. The inter-item reliability of all 31 items of the questionnaire was tested, and the overall satisfaction scale (all items 1–31) produced a high Cronbach’s alpha value of 0.92. Conclusion: Patients’ satisfaction was observed not only for overall satisfaction but also in all sub-scales – context, content, outcome, cost, and facilities.

Drug utilization patterns of antibiotics in outpatient department of educare dental hospital at Malappuram, Kerala, India

Background: Drug utilization studies aims to evaluate factors related to the prescribing, dispensing, administering and taking of medication, and its associated events. Antibiotic prescription by dental practitioners has an important impact on the rate of general antibiotic prescription use, and an attempt has been made to establish a surveillance system for the monitoring and control of the use of these drugs.Methods: Retrospective record-based study was conducted at outpatient department at Educare Dental College and Hospital, Chattipparamba, Malappuram, Kerala. About 2802 prescriptions were screened, drugs prescribed were noted, tabulated and analysed.Results: Total no. of prescriptions 2802, total no. of antibiotics prescribed 2916, average no of antibiotics per prescription 1.04. Out of antibiotics prescribed 72% were monotherapy and 28% were fixed dose combination. Among antibiotics beta lactam antibiotics were commonly prescribed followed by nitroimidazoles and macrolides.Conclusions: The study was conducted to analyze the drug utilization pattern in outpatient department at dental hospital. Most of prescription were rational, both monotherapy and polypharmacy were practiced. Safer drug with less adverse effect profile were considered. Among the antibiotic amoxicillin was the commonest.

Patient satisfaction of outpatient department at ESIS hospital, Nagpur, India

Background: Employee state insurance scheme (ESIS) is a multidimensional social security system providing medical facilities to the insured persons and their family through large network of hospitals and dispensaries all over India. The present study was done to measure the satisfaction of OPD (Outpatient Department) patients.Methods: A descriptive cross-sectional study was conducted in ESI Hospital, Nagpur, Maharashtra, India on 500 patients attending OPD. Patients were approached at the end of their OPD visits to know their perceptions towards the public health facilities, during the months of September and October 2017. Data collected was analyzed.Results: In present study, out of 500 patients, 210 (42%) said that crowd was average, 270 (54%) were satisfied with queue system, 390 (78%) were satisfied with the availability of drugs, 380 (76%) were satisfied with the behaviour of pharmacist.205 (41%) patients said it was not overcrowded, 310 (62%) patients were happy with the behaviour of registration clerk, 330 (66%) were satisfied with the seating arrangements for the patients and attendants, 265 (53%) were satisfied with the cleanliness, 205 (41%) were satisfied with the condition of toilets.390 (78%) patients said that doctor was available, 270 (54%) said that waiting time was less, 325 (65%) said that doctor listened to the problem attentively, 435 (87%) said that the doctor explained nicely about the disease while 425 (85%) were satisfied with the time given by the doctor.Conclusions: Almost half of the patients were satisfied with the registration facilities, basic amenities, service by doctor and pharmacy services. Mostly, patients chose this hospital as it was free for them due to their insurance and as it was near their house. Still, there is scope for improvement.