Availability of access, watch, and reserve (AWaRe) group of antibiotics in community pharmacies located close to a tertiary care hospital in Lalitpur, Nepal.

INTRODUCTION: The access, watch, and reserve (AWaRe) classification of antibiotics was developed in 2019 by the WHO Expert Committee on the Selection and Use of Essential Medicines as a tool to support antibiotic stewardship efforts at local, national, and global levels. The objectives of this study were to assess the availability of antibiotics as per WHO AWaRe classification at community pharmacies located around a tertiary care hospital in Lalitpur and to compare these antibiotics with the national essential medicine list of Nepal. METHOD: The cross-sectional study was conducted at community pharmacies located within a two-kilometer radius of a teaching hospital from August to November 2022. A total of 82 community pharmacies registered with the Nepal Chemist and Druggists Association and the Department of Drug Administration were studied. Data was collected using a standard proforma containing the names of the antibiotics classified as per the WHO's AWaRe classification. RESULTS: Access group of antibiotics, Ampicillin, (82;100%), Amoxycillin, (82;100%), Flucloxacillin, (82;100%), and Metronidazole, (82;100%) were available in all community pharmacies. Results from the watch group showed that Azithromycin, (80; 97.6%) was available in all pharmacies followed by Cefixime, (80; 97.6%), Ciprofloxacin, (73; 89%), Levofloxacin, (74; 90.2%)and Ofloxacin, (74; 90.2%). Linezolid, (24; 29.3%) was the most common antibiotics available from the reserve group of antibiotics. Colistin was the second commonly available antibiotic. The most available antibiotic from the not recommended group were Ampicillin/Cloxacillin (82; 100%), followed by Piperacillin/Sulbactam, (39; 47.6%). There were differences in the classification of antibiotics between the WHO AWaRe list and the Essential Medicines list of Nepal in terms of numbers of antibiotics listed. CONCLUSION: Antibiotics from the not recommended and reserve groups were commonly available in community pharmacies. The implementation of antibiotic guidelines should be emphasized along with strict monitoring of the sale of antibiotics without a prescription in community pharmacy settings.

Ocular Trauma among Patients Visiting the Outpatient Department of Ophthalmology in a Tertiary Care Centre.

Introduction: Ocular trauma is an important cause of blindness and ocular morbidity worldwide. Knowledge of the cause of eye injuries can guide preventive strategies and optimize management capacity. The aim of the study was to find out the prevalence of ocular trauma among patients visiting the outpatient Department of Ophthalmology in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with ocular trauma from 10 January 2023 to 5 July 2023 after obtaining ethical approval from the Institutional Review Committee. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 4,959 patients, 107 (2.16%) (1.76-2.56, 95% Confidence Interval) had ocular trauma. Among them, 24 (22.43%) had occular trauma due to fall injuries. Ocular trauma was observed in 82 (76.64%) males and the common agent was blunt objects seen in 56 (52.34%). Conclusions: The prevalence of ocular trauma among patients was lower than in other studies done in similar settings. Keywords: blunt injuries; injury; ophthalmology; prevalence.

Digital Eye Strain among Adults Presenting to Tertiary Care Hospital in the Era of COVID-19 Pandemic: A Descriptive Cross-sectional Study.

INTRODUCTION: The Novel Coronavirus disease 2019 pandemic has sent humanity indoors, replacing human contact with an electronic connection. The mandatory online classes and work from home policy to maintain the social distancing during the pandemic has forced the individual to spend most of the time in front of laptops or mobile screens. Digital eye strain is a group of vision-related symptoms that result from the continuous use of devices with digital displays, such as computers, tablets, and smartphones. The present study is done to find out the prevalence of digital eye strain among the adult population in a tertiary care hospital in the era of the COVID-19 pandemic. METHODS: This descriptive cross-sectional study was done from January 2021 to July 2021 in a tertiary care hospital of Nepal after receiving ethical approval from the Institutional Review Committee (Registration number: 077/78/30). Convenience sampling was done. The sample size calculated in our study was 322. Data collection and entry were done in Microsoft Excel, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: The prevalence of digital eye strain was 300 (94.3%) (91.8-96.8 at 95% Confidence Interval) among 318 respondents. Eye strain (irritation, heaviness) was the most common digital eye strain symptom 199 (62.6%) followed by the tiredness of eyes 162 (50.9%). CONCLUSIONS: The present study concluded that the prevalence of digital eye strain in the era of COVID-19 is high as compared to other studies conducted among adults.

Antibiotics Use in Hospitalised COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Antimicrobial resistance is a global health problem. The widespread and improper antibiotics use is the leading cause of antimicrobial resistance. Bacterial co-infection in COVID-19 patients is the basis for the use of antibiotics in the management of COVID-19. COVID-19 pandemic has seriously impacted antibiotic stewardship and increased the global usage of antibiotics, worsening the antimicrobial resistance problem. The use of antibiotics among COVID-19 patients is high but there are limited studies in the context of Nepal. This study aimed to find out the prevalence of antibiotic use among hospitalised COVID-19 patients in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted on hospitalised COVID-19 patients from April 2021 to June 2021 in a tertiary care centre. Ethical approval was taken from the Institutional Review Committee (Reference number: 2078/79/05). The hospital data were collected in the proforma by reviewing the patient's medical records during the study period of 2 months. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 106 hospitalised COVID-19 patients, the prevalence of antibiotic use was 104 (98.11%) (95.52-100, 95% Confidence Interval). About 74 (71.15%) of patients received multiple antibiotics. The most common classes of antibiotics used were cephalosporins, seen in 85 (81.73%) and macrolides, seen in 57 (54.81%) patients. Conclusions: The prevalence of antibiotic use among hospitalised COVID-19 patients was found to be higher when compared to other studies conducted in similar settings. Keywords: antibiotics; bacterial infection; co-infection; COVID-19.