Awareness of Adverse Drug Reactions and its Reporting among Third-year Undergraduate Medical Students.

BACKGROUND: Drug is a double-edged sword. Though important, Adverse Drug Reactions under-reporting is real and is mainly due to lack of awareness. No published research has ever evaluated the perspective of third year medical students towards Adverse Drug Reactions reporting. The objective of the study was to evaluate awareness of Adverse Drug Reactions and its reporting among Third-year Medical Students of BP Koirala Institute of Health Science. METHODS: It was a descriptive cross-sectional questionnaire-based survey using google form conducted between 09/01/2020 to 09/28/2020. Any consenting third-year medical student of BP Koirala Institute of Health Science was eligible. Descriptive analysis of the data was performed using Microsoft Excel. Ethical clearance was obtained from Departmental-Research-Unit which is under IRC. RESULTS: Out of 80 eligible students, 79(98.75%) participated in the survey. 31.6(25%) had reported Adverse Drug Reactions. 36.7(29%) were aware of National Adverse Drug Reactions monitoring service. 12.7(10%) were aware of BPKIHS ADR monitoring. Again, 35(49.30%) were familiar with Adverse Drug Reactions to a particular drug whereas 29(40.85%) and 28(39.44%) were even familiar with Adverse Drug Reactions to a new product and Adverse Drug Reactions of serious (life or organ threatening) nature respectively. Regarding barriers to Adverse Drug Reactions reporting, 64(83.12%) were uncertain how to report; 39(50.65%) were unaware of existing National ADR system and 33(42.86) could not decide if it was an Adverse Drug Reactions. Regarding recommendations to improve Adverse Drug Reactions reporting, 73(94.81%) recommended education and training, 57(74.03%) stressed on collaboration among health professionals; 52(67.53%) said Adverse Drug Reactions reporting should be professional obligation whereas 51(66.23%) highlighted feedback from Monitoring Centers. CONCLUSIONS: We evaluated the awareness of Adverse Drug Reactions and its reporting among third-year medical Students of the institute which was relatively poor compared to other study population like doctors and pharmacists.

Typhoid Fever among Admitted Pediatric Patients in a Tertiary Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Typhoid fever, an acute systemic febrile illness caused by Salmonella Typhi & Paratyphi, is an important public health problem in developing countries. It requires frequent observation regarding proper diagnostic protocol and treatment practices. The aim of the study is to find the prevalence of typhoid fever among admitted pediatric patients in a tertiary care center. METHODS: This is a descriptive cross-sectional study conducted among the admitted patients of pediatric and adolescent medicine of a tertiary care center from August 2016 to May 2018 after obtaining ethical clearance (IRC/609/015). Convenience sampling was used and data was analyzed using the Statistical Package of Social version 11.5. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Among 7450 patients, 151 (2.03%) at 95% Confidence Interval (1.71-2.35) patients were diagnosed with enteric fever of which 85 (56.29%) were male and 66 (43.71%) were female. Common symptoms were fever 151 (100%), and abdominal pain 94 (62.25%). Azithromycin 54 (38.03%) was the most common antibiotic received before presenting to hospital and ceftriaxone 151 (100%) was prescribed to all the patients after admission. Two-third of the patients (96/151) was hospitalized for at least 6 days, with the longest hospital stay of 14 days and shortest of 3 days. CONCLUSIONS: Occurrence rate of Typhoid Fever was similar to other studies. Antibiotic susceptibility could not be well established; further surveillance on typhoid fever and the antimicrobial susceptibility pattern is recommended.

Self-medication Practices among the Peri-urban Households of Two Communities of Dharan Sub-metropolitan city of Eastern Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Self-medication practice is the use of medication without prescription of health care professionals. Drug resistance, drug side effects, wastage of resources, and serious health hazards including death are associated with self-medication. We conducted this study to find out the prevalence of self- medication among the peri-urban population of two randomly selected communities of Dharan, Nepal. METHODS: A descriptive cross-sectional study was conducted among people residing in two randomly selected wards of peri-urban areas of Dharan from November 2017 and April 2018 after obtaining ethical clearance (IRC/1030/017). A pretested, structured self-administered questionnaire was used for data collection. Data were collected and entered in Statistical Package for the Social Sciences version 11.5; point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Among 426 respondents, the overall prevalence of self-medication was 312 (73.23%) at 95% Confidence Interval (67.83-78.63%). It was more common among female 158 (78.60%). Common symptoms were headache 201 (64.42%), fever 135 (43.26%), gastrointestinal 93 (29.8%) and respiratory illness 87 (27.88%). Analgesics and antipyretics 275 (88.14%) were the most common drugs self- medicated with. Seeking opinion from pharmacist 112 (35.89%) was the commonest method adopted to procure drugs and comfort 127 (40.7%) and time constraints 122 (39.1%) were the commonest reasons. CONCLUSIONS: Prevalence of self-medication among the peri-urban population was similar to other studies. Headache and fever was the common symptoms for which self-medication were adopted. Awareness regarding potential dangers of self-medication and different drug side effects are recommended at the community level.

Exploring the Prevalence and Correlates of Substance Abuse Amongst the Adolescents of Dharan, Eastern Nepal.

BACKGROUND: The burden of substance abuse amongst the youths has increased worldwide including Nepal. There is limited data on prevalence of substance abuse among the adolescents. Hence this study aims to determine the prevalence of substance abuse amongst the adolescents of Dharan, Eastern Nepal. METHODS: A cross-sectional study was conducted from July 2018 to December 2018. Self-administered structured questionnaire adapted from National Youth Survey sponsored by the Centre for Substance Abuse Prevention was used for data collection from 1125 higher secondary school students. Data was cleaned in Microsoft Excel and analysed using SPSS version 11.5. RESULTS: Prevalence of ever users of tobacco were 46.04% of which the current users were 20.46%, ever users of alcohol were 37.58% of which 15.20% were current users and ever users of drug was 18.19% of which 18.13% were current users. The average age of initiating tobacco, alcohol and drugs were 14.21 ± 3.51, 15.13 ± 7.43 and 14.32 ± 4.41 years respectively. More than half of the drug users (50.71%) used cannabis and the most common reason for using any substance was peer pressure (91.64%). More than one-third (39.5%) purchased any of these substance from local shops. CONCLUSIONS: The study reported significant proportion of adolescents involved in substance abuse. The findings of this study may be beneficial for revising/ updating action plans on prevention and control of substance abuse in Nepal.

Self-medication Practice of Antibiotics among Medical and Dental Undergraduate Students in a Medical College in Eastern Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Self-medication plays significant role in the development of adverse drug reactions, antibiotic resistance, and masking of underlying diseases. Medical students have some knowledge about the use of antibiotics and have a higher chance of irrational and injudicious use. This study aims to find the prevalence of self-medication practice of antibiotics among medical and dental undergraduate students. METHODS: A descriptive cross-sectional study was done among medical and dental undergraduate students from the first year to the fifth year at BP Koirala Institute of Health Sciences from 1st June 2018 to 30th August 2018. Ethical approval was obtained from the Institutional Review Committee (IRC/1210/018). Whole sampling was done. Data was collected using a self-responding, semistructured questionnaire and analyzed using Statistical Package for the Social Sciences version 11.5. RESULTS: In total 558 students, the prevalence of self-medication practice of different antibiotics was 285 (51.1%) within the past year. Among self-medicated students, 152 (53.3%) were males. The common drug self-medicated was Azithromycin 80 (28.1%) and the common medical condition to use non-prescription antibiotics was for treatment of sore throat with runny nose 129 (45.3%). The main source for obtaining non-prescription antibiotics were retail pharmacies 157 (55.1%). CONCLUSIONS: Self-medication with antibiotics was at increasing rate with each succeeding years of the medical courses. Medical students should be made aware of the rational use of antibiotics by incorporating appropriate courses in their academic curriculum for more refined practice on antibiotics rather than advancement of theoretical knowledge alone.

Information about COVID-19 among Selected Population of Eastern Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Rapid spread of COVID-19 has become a major concern worldwide. Strong adherence to preventive measures can help to break the chain of the spread of coronavirus. We conducted this study to find out the extent of information general people of Eastern Nepal have regarding COVID-19 and their attitude and practice towards preventing its spread. METHODS: A descriptive cross-sectional online study was done among the people of Eastern Nepal on knowledge, attitude, and practice related to COVID-19 from May 1st to May 15th after obtaining ethical clearance from the ethical review board (ERB) (ref no. 319/2020 P). A 20 item survey instrument was adapted using WHO course materials on an emerging COVID-19. A convenience sample method was used. Data were collected and entered in Statistical Packages for Social Services version 11.5. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Among 1069 respondents, the correct answer on the COVID-19 related knowledge questionnaire was 958 (89.61%), 487 (93.11%) were health professionals, and 471 (86.26%) non-health professionals. Preventive measures were strictly followed by 1044 (97.66%) participants. A wrong perception about the disease was present in 390 (36.48%). Health ministry website 356 (33.30%) followed by news media 309 (29%) was the major source of information among the people. CONCLUSIONS: Knowledge regarding COVID-19 among people the selected population of eastern is satisfactory which was similar to other studies done. However, people still have misperceptions regarding the disease and do not strictly follow the preventive measures.