scholarly journals Observational and cross-sectional study of prescription pattern in the pediatric out-patient department at a tertiary care center of Bihar

Author(s):  
Asha Singh ◽  
Murli Manohar

Medical therapy is the most common form of health care provided to the patients. More the practice, more the error is substantiated by the fact that medication errors are probably the most common medical error. Detailed information on these errors is the first step to prevent these errors becoming a health hazard for the individual as well as the society. To generate data on the extent of rational/irrational prescribing pattern, to review the prescribing practices.An observational study with cross sectional design Prescriptions of the patients attending the pediatric OPD were reviewed to collect required data.1200 prescriptions were reviewed that had 3384 drugs listed. The mean age was 8.3± 4.62 years with male> female. Weight of the patient was recorded in 82.8% of the prescriptions. The average number of drugs per prescription was 2.82. The range of drugs per encounter varied from zero to 5. Ailments like minor scratches or other non-organic problems were those where no drugs were prescribed. Around 50% of the drugs prescribed were in generic names. Syrups were most commonly prescribed followed by tablets and capsules. Injection use was very less. Antibiotics were widely used for treatment with 73.8% of the prescriptions had at least one antibiotic.The findings of the current study highlight the continuing crisis of the irrational drug practice in this part of the country. This will help authorities to take necessary action and formulate guidelines on proper and rational drug prescription.

Author(s):  
Mrityunjay Kumar Pandit ◽  
Kumar Gaurav ◽  
Jeetendra Kumar

Making affordable drugs accessible to all strata of society is an inevitable part of health care. This situation makes Drug Utilization Study inevitable. With this background, the current study was planned to obtain knowledge on the prescribing pattern and drug utilization trend in ophthalmology department at a tertiary care teaching hospital with ultimate goal to promote rational use of drugs among prescribers. An observational cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between March 2021 and August 2021. Prescriptions of 550 patients who were treated during the course of the study were surveyed prospectively by using a specially designed form. The WHO drug use indicators like prescribing indicators and patient care indicators were determinedThe average number of drugs per prescription was 2.6, ranging from 0-7 drugs. The dosage forms, the frequency of administration and duration of treatment of the drugs were recorded for 99.9% of the prescriptions given. This analysis of the prescriptions showed that 93.8% of the prescriptions were written in the form of various trade names. Antibiotics were prescribed in 52.5% of the prescriptions. The present study revealed certain lacunae in the prescribing practices of the Ophthalmologists at the selected institute and this is evident by the low generic prescribing in many prescriptions.


Author(s):  
Saswat Satapathy ◽  
Yajnesh P. Sahu ◽  
Ashok K. Panigrahi ◽  
Bhabagrahi Rath ◽  
Ananta N. Patra

Background: The intensive care unit is a setting where the multiple medications are prescribed to patients. Antimicrobials are heavily prescribed in the ICUs, which in turn enhance the risk of antimicrobial resistance, increase the side effects and increases the cost of treatment. Drug utilization study is a component of medical auditing that aims to monitor and evaluate the drug prescription patterns and to suggest necessary modifications in the prescribing practices to achieve rational therapeutic practice.Methods: A cross-sectional study was conducted in which data of patients admitted to ICU during the period from June 2019 to August 2019 was collected from the Medical Record Section of the hospital. Drug utilization pattern of antimicrobials in ICU was analyzed.Results: Out of 90 patients, 60 were males and 30 were females. The average duration of stay in ICU was 7.53 days. The most common antibiotic prescribed was ceftriaxone followed by piperacillin and tazobactam with DDD/100 bed days of 24.2 and 17.3 respectively.Conclusions: In this study, the results appeared to be similar to those reported in previous studies. However, prescription protocols need to be addressed to guide appropriate use of antimicrobials in the ICU setting. Therefore, it is necessary to conduct drug utilization research to understand the drug consumption and for implementation of protocols to improve the quality of healthcare. 


Author(s):  
Nayana J. Gohil

Background: Evaluation of drug prescription prototype is a significant feature of patient care, which also provides as an estimate of the quality of care provided. Thus, the current study was carried out to analyze the prescriptions of patients attending outpatient department (OPD) of a tertiary care teaching hospital.Methods: Present cross-sectional study was performed in the OPD of our tertiary care teaching hospital. The study was carrying out for duration of two years. Data was obtained from 850 prescriptions. Data was analysed as per WHO prescribing indicators.Results: Total 1700 prescriptions were analysed, that includes 55.8% males and 40.1% females. The highest numbers of prescriptions were from the age group of 18-40 (53.6%) years of age. Average number of drugs in the current study was found to be (2.1). Percentage of come across with an antibiotic prescribed was 17.12%. Percentage of come across with an injection prescribed was 11.81%.Conclusions: There is necessitate of recuperating the prescribing pattern by maintaining the number of medicines as little as possible, prescribing medicines by generic names, using medicines properly after selecting and deliberately keeping the charge of treatment low.


Author(s):  
Asha Singh ◽  
Murli Manohar

Fungal infections take a toll on the health of all individuals, irrespective of ages, gender, ethnicity etc. But still major researchers have focused on antibacterial rather than antifungal till recent past, when the limelight has moved to antifungal medicines. Adding to the gravity of the situation, is the growing resistance against these drugs. Keeping these facts in mind, this study was planned to delineate the prescribing pattern of antifungal drugs by the various specialty in a tertiary care center in the eastern part of the country. This was an observational and cross-sectional hospital-based study. The study incorporated 218 patients from various departments of the hospital during the study duration that was from March 2021 to September 2021. Descriptive statistics was performed using SPSS ver 20.0. Results has been depicted in formof text and table. Antifungal medicines prescribed mostly for leukemia and other immunocompromised status. Most of the patients came from the department of general medicine. Majority of the patients had hematological disorders followed by infections. Anidulafungin was reported to have been prescribed most commonly by the department of surgery in patients with solid tumors. Patients with lung infections also received this drug by physicians. This use can be justified by its action against invasive aspergillosis, oesophageal candidiasis and peritonitis and intraabdominal abscess caused by candida species. Ketoconazole and clotrimazole were the least used antifungal agents in our study. These two agents are mainly indicated for topical use The current report will aid in understanding antifungal prescription practices. This will also form a basis for future researches and formulating guidelines for rational use of these drugs.


Author(s):  
Keerthana Dhandapani ◽  
Bhagyalakshmi Kodavanji ◽  
Vinodini Nithyananda Madom Anantharaya ◽  
Nayanatara Arun Kumar

Abstract Objectives Infertility has disastrous consequences, particularly for women. Causes of infertility in developed countries have been investigated but there is a significant lack of data among Indian female population. The aim of the present study was to analyze the causes and the proportion of the individual factors contributing to infertility, considering the age factor. Methods The data of 204 infertile women (18–45 years) were collected from the files in tertiary care hospitals. Causes and age of infertile women were grouped. The prevalence of each cause was evaluated. Data analysis was done using SPSS (Statistical Package for Social Sciences) version 17.0. Results Polycystic ovarian syndrome (PCOS) was the most common (14.71%) cause of female infertility. Ovulatory dysfunctions (25.55%) were the foremost cause in primary infertility, whereas in secondary infertility, uterine factors (26.86%) were most common. The incidence of primary and secondary infertility was more evident in patients who were more than 30 years of age. Conclusions Causes of infertility vary according to the age. The causes of female infertility were unexplained infertility, ovulatory disorders and uterine factors most commonly affecting women at ≤30 years.


Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.


2021 ◽  
pp. 1-10
Author(s):  
Ryan J. Huang ◽  
Sherri L. Smith ◽  
Libor Brezina ◽  
Kristal M. Riska

Purpose There is a paucity of data that directly compares the falls rate and dizziness handicap of different vestibular diagnoses. The purpose of this study is to compare the falls rate and dizziness handicap of common vestibular diagnoses encountered among a cohort of vestibular patients at a single institution. Method We conducted a retrospective cross-sectional study of patients evaluated for dizziness at a tertiary care center vestibular clinic between August 1, 2017, and March 19, 2019. Vestibular diagnosis, demographic variables, comorbidities, falls status, and Dizziness Handicap Inventory (DHI) were extracted from the medical record for analysis. Associations between vestibular diagnosis and falls history or DHI were evaluated using multivariate logistic and linear regression, respectively. Results A total of 283 patients met our inclusion criteria with the following diagnoses: benign paroxysmal positional vertigo (BPPV; n = 55), acoustic neuroma ( n = 30), Ménière's disease ( n = 28), multiple vestibular diagnoses ( n = 15), vestibular migraine ( n = 135), or vestibular neuritis ( n = 20). After adjusting for age, sex, race, medications, and comorbidities, the odds of falling was 2.47 times greater (95% CI [1.08, 6.06], p = .039) and the DHI score was 11.66 points higher (95% CI [4.99, 18.33], p < .001) in those with vestibular migraine compared to those with BPPV. Other diagnoses were comparable to BPPV with respect to odds of falling and dizziness handicap. Conclusions Patients with vestibular migraine may suffer an increased risk of falls and dizziness handicap compared to patients with BPPV. Our findings highlight the need for timely evaluation and treatment of all patients with vestibular disease.


2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 


Author(s):  
Mrityunjay Kumar Pandit ◽  
Kumar Gaurav ◽  
Jeetendra Kumar

Hypertension is among the most common non-communicable and lifestyle disease in our country that affects adult population of both the genders from all socio-economic backgrounds and urban and rural population. In-spite of this, early diagnosis and appropriate treatment are suboptimal. Adherence of prescribed treatment has been studied in patients of hypertension in this study. : An observational and cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between January 2021 and June 2021.A predesigned pretested interview schedule was used to collect the data from the 247 study participants. This schedule contained information related to socio-demographic variables, comorbidity, a format to assess the compliance to antihypertensive drugs prescribed and any adverse event. : A significant improvement in maintain optimal in blood pressure was observed in patients treated with one pill per day as compared to patients prescribed with two and three pills per day. Compliance was significantly better in patients in combination therapy as compared to monotherapy. : Low dose combination therapy has been stated to be more effective than high dose monotherapy in controlling blood pressure. It shows better compliance and lesser incidence of side-effects.


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