Antibiotics Use in a Tertiary Care Hospital Using Point Prevalence Survey Method.

BACKGROUND: Point prevalence survey on antibiotic use developed by WHO are already in use in acute care hospitals around the world. The aim of this study was to collect prescribing of antibiotics using Point prevalence survey method in KIST Medical College and Teaching Hospital. METHODS: This was a cross sectional descriptive study and data collection was completed within 8 working days in the study site. The study was conducted among inpatients admitted at or before 8:00AM on the day of survey in various wards. Patient sampling was done as per the Point Prevalence Survey methodology. Data analysis was done and presented as frequencies and percentages. RESULTS: Out of 32 patients, maximum patients were of age group 20-30 years and 19 (59%) patients were females. Most patients, 8 (32%) were from the surgery ward. There were patients from 8 different wards including a patient who had renal transplant. Blood, sputum, urine and CSF culture were done in 11 patients, only 2 urine cultures were positive. At least one antibiotic was used among 18 patients. Ceftriaxone (34.4%) was maximally used followed by levofloxacin (3%). One or two antibiotics were used in prophylaxis with a duration of one to five days. CONCLUSIONS: WHO Point prevalence survey methodology has been used in this study. Ceftriaxone was the most commonly used antibiotics. Parenteral administration was the commonest method of administration. At least one antibiotic was used among 18 patients. There is presence of a functioning Drugs and Therapeutics Committee, Infection Prevention and Control Committee and committee on pharmacovigilance. However, many indicators for hospital infrastructure, policy and practice and monitoring and feedback were not present.

Diabetes Mellitus among Adult Outpatients Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Diabetes mellitus is a chronic metabolic disease characterised by elevated blood sugar levels and is a pandemic of public health importance. Screening programs can help reduce morbidity and mortality by preventing or delaying complications. This study aimed to find out the prevalence of diabetes mellitus among adult outpatients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among outpatients visiting a tertiary care centre between 1 January 2019 to 31 December 2019. Ethical approval was obtained from the Ethical Review Board (Registration number: 408/2020 P). Patients with unknown history of diabetes participating in free random blood sugar examinations were included in the study. Systematic random sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 385 adult outpatients, 17 (4.42%) (2.37-6.47, 95% Confidence Interval) had diabetes. The mean random blood sugar level of the diabetic patients was 281.41±57.49 mg/dl. Conclusions: The prevalence of diabetes mellitus among adult outpatients was similar to previous studies conducted in similar settings. Random blood sugar test in hospital outpatient settings is feasible to identify people with diabetes mellitus. Keywords: diabetes mellitus; hospital; Nepal; outpatient.

Prevalence of Self-medication among MBBS students of a Medical College in Kathmandu.

INTRODUCTION: Self-medication refers to self-prescription which includes diagnosing and treating one's own illness and prescribing for one's self. Though appropriate self-medication relieves acute symptoms, is time saving and economical, it should not be advocated because of more risks than benefits. Self-medication practices were found to vary in medical students of Nepal and India. This study was aimed to determine the prevalence of self-medication among medical students. METHODS: This descriptive cross-sectional study was conducted among 76 MBBS students. The study involved the administration of the research questionnaire including demographic information, practice of self-medication, type of illness, factors influencing self-medication, commonly self- prescribed drugs, sources and strategies to reduce such practices. The data were analyzed using Graph pad prism version 6. RESULTS: The prevalence of self-medication was 58 (76.6%), more common among first year students. The common illness found was headache and common drug self-prescribed was analgesic-antipyretic. The most common source of obtaining medicines for all three year medical students was pharmacy. Students were also prescribing medicines to family members, friends and juniors. More than half of the students 52 (68.4%) reported that self-medication practices should be encouraged. CONCLUSIONS: Self-medication had been widely practiced among medical students. Self-medication can relieve medical problems but also involve the risks of adverse drug reactions, resistance and masking of underlying diseases. Medical students should be given enough exposure for better understanding of rational prescribing to minimize self-medication. The further study on practice of self-medication is needed on various health professionals and even in general community.

Adherence is associated with the quality of professional-patient interaction in Directly Observed Treatment Short-course, DOTS.

OBJECTIVE: To investigate the association between the behaviour of health professionals as reported by patients, the quality of communication, patients' communication about their disease, and non-adherence to Directly Observed Tuberculosis Treatment Short-course, DOTS. METHODS: This study was designed as a case-control study based on 50 cases (non-adherents) and 100 controls (adherents), conducted in a hilly western district in Nepal. The participation rate was 80% for 50 cases and 95% for 100 controls. All covariates with p-value

Intervention studies on rational use of drugs in public and private sector in Nepal.

In developing countries, inappropriate, inefficient and ineffective use of pharmaceuticals have resulted into the poor health and medical cares for the community people. For improving the situation, various interventions have been tested and proved effective in different settings. In Nepal also, various strategies have been tested and found effective to improve the prescribing and dispensing practices. This paper has examined the process and results of different studies. The educational intervention, the training has not been effective in improving the prescribing practices but has limited effect on dispensing practices in the public sector. However, it becomes effective in improving prescribing practices if combined with a managerial intervention e.g. peer-group discussion. In private sector, training alone is effective in changing the drug recommendation practices of retailers. But none of interventions have been found to be effective in improving dispensing practices. After examining the effectiveness of different interventions, training combined with peer-group discussion is recommended for piloting in all Primary Health Care (PHC) outlets of a district to improve the prescribing practices. For improving the dispensing practices in both public and private sector, additional studies have to be carried out using different strategies.