scholarly journals Assessment of knowledge, attitude and practices among the residents and interns about rational fixed drug combinations in tertiary health care centre in Central India

Author(s):  
Pallavi Admane ◽  
Sachin Hiware ◽  
Mohini Mahatme ◽  
Sujata Dudhgaonkar ◽  
Mukunda Bargade ◽  
...  

Background: Fixed drug combination (FDC) is a combination of two or more active drugs in a single dosage form. Rational fixed drug combination improves patient compliance, enhances the efficacy of combination and minimizes side effects. But unfortunately, many FDCs introduced in Indian market are irrational. Prescription of irrational FDCs increases morbidity, mortality, treatment failure, emergence of resistance and financial loss to community. Since junior doctors like residents and interns are the backbone in patient care in the tertiary care hospital, knowledge of FDC in them has paramount importance.Methods: A prospective, cross sectional, observational study was carried out to assess the knowledge, attitude and practice about the use of FDC by junior resident doctors and interns. A pre-validated questionnaire was given to two hundred doctors from various departments and data was analyzed. Questions were based on knowledge of National Essential List of Medicine (NELM), rational FDC and criteria of rationality.Results: Seventy six percent health care professionals had the knowledge of FDC. Only 48% were aware about FDCs mentioned in WHO Essential List of Medicine. Most of them were aware of advantages and disadvantages of FDCs. Common sources of information were medical representatives, textbooks and Current Index Of medical Specialities (CIMS). Fifty eight percent doctors preferred to prescribe FDC, and ninety two percent avoid use of irrational FDCs. Most commonly prescribed rational fixed drug combination was amoxicillin + clavulanic acid. Paracetamol + ibuprofen was the most commonly prescribed irrational FDC.Conclusions: There is need to improve knowledge of rational fixed drug combination, NELM list.

Author(s):  
Kaksha J. Patel ◽  
Ashwin K. Panchasara ◽  
Manish J. Barvaliya ◽  
C. B. Tripathi

Background: The objective of the study was to study the clinical patterns, causality and severity of adverse drug reactions in a tertiary care hospital.Methods: Total 131 ADR forms were collected from January 2012 to December 2012 and evaluated. Patient’s characteristics, ADR and drug characteristics, causality, severity and preventability of collected ADR were analyzed.Results: Total 131 ADR forms were evaluated. Male patient experiencing ADR were more (73, 55.7%) than female (58, 44.2%). Adult patients (12-60 years) experienced 110 (84%) ADR followed by pediatric patients (< 12 years) 11 (8.4%) and geriatric patients (>60 years) 10 (7.63%). Antimicrobial were the most common group of drugs responsible for ADR followed by NSAIDs and antipsychotic group.Conclusions: Present study shows lack of awareness among health care professionals for reporting of an ADR. Training and collaboration of health care professionals are needed for improvement in ADR reporting. Appropriate feedback from ADR reporting will help in selection of drug and promotes safer use of drugs.


Author(s):  
Latha T ◽  
Anil K Bhat ◽  
Manjunatha Hande H ◽  
Chiranjay Mukhopadyay ◽  
Elsa Sanatombi Devi ◽  
...  

 Objective: The aim of this study was to find the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carrier status in anterior nares and hands of health-care professionals working in orthopedic wards of a tertiary care hospital and to decolonize them to reduce spread of MRSA to their patients.Methods: The study was conducted in a super specialty, tertiary care teaching hospital. The samples were collected from anterior nares, palm, web spaces, and fingertips of 140 health-care professionals (48 doctors, 74 nurses, and 18 technicians) working in orthopedic wards using sterile pre-moistened swabs. MRSA carrier status was identified by Kirby-Bauer disc diffusion method.Result: Most (76.4%) of the health-care professionals were <30 years of age and 51% were male. MRSA in anterior nares of doctors was 4.3%, nurses 1.4%, and technicians 0.7% and none had MRSA in their hands. Methicillin-sensitive Staphylococcus aureus (MSSA) growth was more among nurses (nurses - 5.7%, doctors - 2.1%, and technicians - 1.4%) in anterior nares. In addition, 1.4% nurses’ hands were colonized with MSSA. Both MRSA and MSSA carriers were decolonized effectively and repeat sampling showed no growth.Conclusion: Health-care professionals have a greater chance of transmitting MRSA to patients and orthopedic patients are more susceptible for infection. Although MRSA carrier status was not very high among orthopedic health-care professionals compared to previous studies, it cannot be ignored. Nasal mupirocin and bath with chlorhexidine soap were effective in decolonization. Periodic screening and treatment of colonizers would help in elimination of MRSA carriage.


2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Christian Urbanek ◽  
Jana Kötteritzsch ◽  
Wolfgang Zink ◽  
Armin J. Grau

Abstract Background and aims At present, “severe acute respiratory syndrome new coronavirus” (SARS-CoV-2) affects the whole world and has led to a pandemia with almost 2.000.000 infected patients in the mid of April 2020 (WHO). Thus, health care specialists primarily focus on therapy of corona disease 2019 (COVID-19) and a lot of effort has been undertaken to get more manpower on intensive care units. However, the number of patients with life threatening diseases other than COVID-19 like heart attacks or strokes has not changed at all. With a strong focus on COVID-19, there is a marked risk of diagnostic and therapeutic delays or misdiagnoses, potentially harming those patients. In this respect, we present two of those cases with the intent to improve the medical management of “traditional“ diseases in times of corona pandemia. Methods We present two patients with diseases others than SARS-CoV-2. Both cases were treated in our institution, a tertiary care hospital in the Southwest of Germany. Results One patient had a prolonged treatment on intensive care unit (ICU) because of heart failure following voluntary isolation because of fearing COVID-19 and subsequent shortage of medication. Another patient with hypothesis of COVID-19 of primary care physician because of fever and a history of skiing in a high risk region for SARS-CoV-2 was sent home for isolation. After disease progression, the patient presented in an external hospital with fever, pain in the right ear and tachypnea. Immediately, antibiotics were started at same day, but nevertheless, he developed a septic shock, leading to multi organ failure. In blood samples, bacteria Streptococcus pyogenes was found, without any signs of SARS-CoV-2-infection. Despite adequate antibiosis, the patient developed fixed pupils, brain edema and died because of massive brain edema. Conclusion Focusing only on COVID-19 may lead to delayed diagnosis and therapy in patients with “traditional diseases”. These two cases impressively clarify medical challenges in times of SARS-CoV-2 pandemia. It is important to emphasize that physicians and health care professionals have not only to focus on COVID-19 and virus associated diseases, but also on adequate drug supply, intake and monitoring and differential diagnoses, respectively.


2019 ◽  
Vol 9 (1) ◽  
pp. 8-12
Author(s):  
Cency Baburajan ◽  
Sakthi Arasu ◽  
Ramesh Naveen

Background: In the last decade, research conducted in different countries has shown that bullying in the health care sector especially among nurses is a widespread and serious problem. Bullying of nurses at workplace affects their quality of life, hinders delivery of quality healthcare and contributes to increase in workplace stress. So, this study was conducted to assess the prevalence of work place bullying among nurses working in a tertiary care hospital in Bangalore. Methods: This study was conducted among 300 staff nurses providing in-patient services in a tertiary health care hospital located in Bangalore. The required sample was selected utilizing the documents maintained in the office of Chief of Nursing Services and using computer generated random numbers. The data was collected using self-administered questionnaire which comprised of socio-demographic factors and Negative Acts Questionnaire-Revised. Results: Among the 297 respondents, 26.9% were victims of bullying in the past six months according to Negative Acts Questionnaire-Revised (NAQ-R). Among the participants who were bullied, those exposed to work-related bullying, person-related bullying and physical intimidation were 80%, 60% and 21.3% respectively. Conclusion: This study suggests existence of work place bullying among nurses which can adversely affect their performance as health care professionals and their quality of personal life.


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