scholarly journals Evaluation of One-Year Antibiotics Utilization in the Adult Outpatient Pharmacy of a Nigerian Tertiary Health Institution

2020 ◽  
Author(s):  
Angus N. OLI ◽  
Nwanneka ONYEASO ◽  
Stephen Chijioke Emencheta ◽  
Chijioke M. OFOMATA ◽  
James-Paul KRETCHY ◽  
...  

Abstract Background: Antibiotics are among the most common drugs used worldwide.They kill or prevent the growth of bacterial microorganisms in the body, hence, they are the major agents used in treating bacterial infections. Because they are prone to abuse and misuse, regular evaluation of their utilization is important for optimal healthcare delivery.Objective: This study determined the antibiotics type, utilization, prescriptions and cost patterns in the adult out-patient pharmacy of a public tertiary health facility in Nigeria.Methods: This is a retrospective observational study using medication utilization records (prescriptions) to investigate the study objectives. Prescriptions dispensed in 2018 in adult out-patient pharmacy of Nnamdi Azikiwe University Teaching Hospital, Nnewi were reviewed. Data were evaluated using the World Health Organization-developed prescribing indicators. Descriptive and inferential statistics were used to analyze the results. The percentage and averages of the variable were calculated.Results: The medication utilization records showed that there was a significantly higher proportion (P-value = 0.0038) of females (70%) compared to males (the ratio being 2.44:1.00) that were prescribed antibiotics. The antibiotic utilization profile showed that antibiotic selection by class was significantly different and accounted for 44.02% of the total variance seen in the prescription pattern (P-value is < 0.0001). Also, the age of participants accounted for 19.48% of the total variance seen in the selection practice and so, age significantly affected the selection practice/prescription pattern with P-value < 0.0001. Dosage forms profile showed that the oral dosage forms were significantly more prescribed (P-value < 0.0001) compared with any other dosage form encountered in the study. There was no significant difference in the prescription patterns of parenteral and other dosage forms (P-value > 0.05). A greater percentage (84.22 %) of the prescriptions was from the Essential Drug list of Nigeria. Conclusion: Though the percentage of antibiotics prescribed from essential medicines list was found to be satisfactory, a strict protocol for prescribers is required to promote rational antibiotics use. This would not only prevent antibiotic resistance but also reduce the treatment expenditure and encourage antibiotic stewardship.

2018 ◽  
Vol 1 (2) ◽  
pp. 114
Author(s):  
Wahdaniah Wahdaniah ◽  
Sri Tumpuk

Abstract: Routine blood examination is the earliest blood test or screening test to determine the diagnosis of an abnormality. Blood easily froze if it is outside the body and can be prevented by the addition of anticoagulants, one of which Ethylene Diamine Tetra Acetate (EDTA). Currently available vacuum tubes containing EDTA anticoagulants in the form of K2EDTA and K3EDTA. K3EDTA is usually a salt that has better stability than other EDTA salts because it shows a pH approaching a blood pH of about 6.4. The purpose of this research is to know the difference of erythrocyte index results include MCH, MCV and MCHC using K3EDTA anticoagulant with K2EDTA. This research is a cross sectional design. This study used venous blood samples mixed with K2EDTA anticoagulant and venous blood mixed with K3EDTA anticoagulants, each of 30 samples. Data were collected and analyzed using paired different test. Based on data analysis that has been done on MCH examination, p value <0,05 then there is a significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value. Then on the examination of MCV and MCHC obtained p value <0.05 then there is no significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value.Abstrak: Pemeriksaan darah rutin merupakan pemeriksaan darah yang paling awal atau screening test untuk mengetahui diagnosis suatu kelainan. Darah mudah membeku jika berada diluar tubuh dan bisa dicegah dengan penambahan antikoagulan, salah satunya Ethylene Diamine Tetra Acetate (EDTA). Dewasa ini telah tersedia tabung vakum yang sudah berisi antikoagulan EDTA dalam bentuk  K2EDTA dan  K3EDTA. K3EDTA  biasanya berupa garam yang mempunyai stabilitas yang lebih baik dari garam EDTA yang lain karena menunjukkan pH yang mendekati pH darah yaitu sekitar 6,4. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan hasil indeks eritrosit meliputi MCH, MCV dan MCHC menggunakan antikoagulan K3EDTA dengan K2EDTA. Penelitian ini merupakan penelitian dengan desain cross sectional. Penelitian ini menggunakan sampel darah vena yang dicampur dengan antikoagulan K2EDTA dan darah vena yang dicampur dengan antikoagulan K3EDTA, masing-masing sebanyak 30 sampel. Data dikumpulkan dan dianalisis menggunakan uji beda berpasangan. Berdasarkan analisis data yang telah dilakukan pada pemeriksaan MCH didapatkan nilai p < 0,05 maka ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit. Kemudian pada pemeriksaan MCV dan MCHC didapatkan nilai p < 0,05 maka tidak ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit.


Author(s):  
Katarzyna Dereń ◽  
Justyna Wyszyńska ◽  
Serhiy Nyankovskyy ◽  
Olena Nyankovska ◽  
Marta Yatsula ◽  
...  

Overweight and obesity, as well as underweight in children and adolescents, pose a significant public health issue. This study aimed to investigate the secular trend of the incidence of underweight, overweight, and obesity in children from Ukraine in 2013/2014 and 2018/2019. The studies were conducted in randomly selected primary and secondary schools in Ukraine. In total, 13,447 children (6468 boys and 6979 girls) participated in the study in 2013/2014 and 18,144 children (8717 boys and 9427 girls) participated in 2018/2019. Measurements of body weight and height were performed in triplicate. Underweight, overweight, and obesity were diagnosed according to the standards of the World Health Organization (WHO). In the group of girls, a significant difference between 2013/2014 and 2018/2019 measurements was found only among 7-year-olds. The percentage of girls at this age exceeding the body mass index (BMI) norm was lower in the 2018/2019 study. In boys, a significant difference was also found in 7-year-olds, and, as in girls, a lower share of overweight and obesity was found in 2018/2019. But for the ages of 12, 13, and 15, the significant differences had a different character—more overweight or obese boys were found in the 2018/2019 study. The proportion of underweight children was similar for the majority of age groups in both genders and did not differ in a statistically significant way.


2019 ◽  
Vol 10 (2) ◽  
pp. 276
Author(s):  
Yusari Asih ◽  
I Gusti Ayu Mirah WS

<p><span>Baby Massage and Spa was a traditional effort that uses a holistic approach through comprehensive care using a combination of massage and water therapy methods that are carried out in an integrated manner to balance the body, mind, and feelings. Age 3-6 months is the right time for babies to do massage and spa. The purpose of this study was to determine the effect of baby massage and spa on the growth of infants aged 3-5 months in Pringsewu District in 2018. This study uses a quasi-experimental approach with research design pre and post-test with control group design. The purposive sampling technique was taken with a sample of 30 infants as the intervention group and 30 infants as the control group. Data were processed using computerization and analyzed using the T-Test. The results showed that there were significant differences between body weight, body length and baby head circumference in the pre and post-treatment. There was no significant difference in the average increase in infant weight between babies who were carried out by baby massage and spa with babies who were not carried out by baby massage and spa with p-value 0.116. There is a significant difference in the baby's body length and head circumference performed by baby massage and spa with those not carried out by baby massage and spa with p-value 0.000. Baby Massage and Spa has a significant effect on increasing the growth of babies aged 3-5 months.</span></p><p><span> </span></p>


Discoveries ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e119
Author(s):  
Shah Newaz Ahmed ◽  
◽  
Ratinder Jhaj ◽  
Ritendra Patidar ◽  
Mahendra Dangi ◽  
...  

Background: The Anatomical Therapeutic Chemical Classification / Defined Daily Dose (ATC/DDD) system recommended by World Health Organization is accepted worldwide as the standard method of quantification of drug consumption. However, owing to individual variation in body weight, the ATC/DDD system cannot be used for comparison across paediatric population. Objective: This study aimed to develop a novel metric system for standard quantification of antibiotic consumption in paediatric population. Method: The standard unit of drug quantification in adult population is DDD/100 patient days (PD). We conceived a new unit of DDD/1000 kg-days (KD) where KD is the product of the body weight and length of hospital stay of an individual patient. We simulated the quantification and comparison of drugs in a computer model of five virtual paediatric hospitals (H1 to H5, n=100, 200, 100, 100, 100 respectively). We re-applied the metric system on two, real world, hospital-based, time cohorts (TC) (TC18, n=38 and TC19, n=47) of 2 weeks each, in two consecutive years. Results: The body weights (mean±SD) in H1-H5 were 5.7±3.0, 5.7±2.8, 25.3±8.5, 20.6±11.7 and 19.8±11.4 kg, respectively. The antibiotic consumption in terms of DDD/100 PD and DDD/1000 KD in the five hospitals was 1.26, 1.20, 5.52, 4.41 and 2.00, and 2.24, 2.14, 2.22, 2.17 and 1.06 respectively. In TC18 and TC19, the mean body weight, DDD/100 PD and DDD/1000 KD were 12.24±13.17, 30.93, 20.34 and 19.51±12.28, 11.99, 6.23, respectively. Conclusion: DDD/1000 kg-days is a potential standard unit for drug quantification in paediatric population independent of weight distribution and size of the study sample. The universal application and comparison across diverse samples can generate useful information for resource allocation, anti-microbial stewardship, disease burden and drug use, and can help in taking policy decisions to improve healthcare delivery in the paediatric population.


2020 ◽  
Vol 14 (2) ◽  
pp. 114
Author(s):  
Yeli Hartuti ◽  
Efriyeldi Efriyeldi ◽  
Maria Erna

Air pollution gives a negative impact to human health due to pollutants released by motor vehicles. From the several kinds of pollutants generated, CO is one of the most pollutants released by motor vehicles. Lead can contaminate the environment and can poisoning the living organisms. Lead can cause various disorders to the body and also organs such as hematopoietic system, neurological, endocrine, renal, gastrointestinal, hematological, and reproduction. This study aims to analyze the comparison of the levels of lead (Pb) in fried foods sold on Jalan Sam Ratulangi with fried foods sold on the edge of Jalan Purwodadi, Pekanbaru City. This research is descriptive quantitative. Samples in the form of bakwan which were taken by one trader by using a total sampling of 6 samples. The sample will then be examined quantitatively to determine the level of lead in the sample using the atomic absorption spectrophotometric method. The results of the lead level examination will then be compared with the maximum limit of metal contamination according to the standards set by the Directorate General of Drug and Food Control No. 00.06.1.52.4011 Year 2009 to find out whether the fried foods sold in that location meet the Threshold Value (NAB), and compared using the SPSS t test. The results of the research after analysis using the t test, it is known that the p value is 0.216 when compared with a= 0.05, then p>a, so there is no significant difference between the fried foods sold on Jalan Sam Ratulangi and Purwodadi, Pekanbaru City, all samples exceed The threshold value set by the Regulation of the Director General of Drug and Food Control Number HK.00.06.1.52.4011 of 2009 is 0.25 mg/kg.


2020 ◽  
Vol 34 (4) ◽  
pp. 361-366
Author(s):  
Edcleide Oliveira dos Santos Olinto ◽  
Gina Araújo Martins Feitosa ◽  
Izaura Odir Lima Gomes da Costa ◽  
Janine Maciel Barbosa ◽  
Ericka Vilar Bôtto Targino ◽  
...  

Introduction: There is a strong relationship between malnutrition and increased length of hospitalization and morbidity and mortality. Studies have shown that malnourished patients can have up to twenty times more complications than eutrophic ones. In critically ill patients, there is a tendency to catabolism, resulting in the loss of lean body mass, which when it reaches 40% is usually lethal. Methods: A quantitative, descriptive study was conducted on adults from both genders, admitted to the intensive care unit (ICU) of a university hospital, from March to December 2018. The following variables were collected from the evaluation and nutritional records: length of hospitalization in the ICU, date of discharge or death, nutritional risk through specific screening, height, weight and arm circumference (AC). For the screening, the Nutric score was used. For the nutritional evaluation, the body mass index (BMI) and AC indicators and the classifications recommended by the World Health Organization (2004) and Blackburn and Thornton (1979) were used. After collecting the data, they were analyzed in the Statistical Package for Social Sciences (SPSS) 13.0 and for the association of the variables the Chi-square test was used, considering statistical difference when the p value <0.05. Results: The sample consisted of 116 patients, mostly female (53.4%) whose median age was 46 years (interquartile range IQR 31-53). Regarding the frequency of nutritional risk, most patients (61.5%) had a low score. There was an important frequency of malnutrition, according to the AC indicator (73%), although BMI (43.5%) showed eutrophy. Even though most patients had low nutritional risk, those with high nutritional risk (38.5%) had a higher tendency to mortality, however, not statistically confirmed (p> 0.05). There was also a tendency of association between death and malnutrition, although no statistical significance was shown(p> 0.05). Conclusion: Patients at nutritional risk and/or malnutrition appear to be vulnerable to worse clinical outcomes.


2013 ◽  
Vol 03 (03) ◽  
pp. 038-041
Author(s):  
Shobha S. Shetty ◽  
Hrishikesh Nachane

Abstract Background: Smoking has been shown to have a positive effect on DNA damage in almost all the cells of the body. Quantitative analysis of this damage will help in assessing the etiopathogenesis of various nicotine induced damage to the body. Comet assay has been an emerging tool in this regard and hence was applied by us to estimate the severity of DNA damage in smokers. Aims & Objectives: To evaluate the DNA genotoxicity in peripheral blood lymphocytes in smokers and their comparison with non smokers & assess the quantitative damage. Materials and methods: 30 smokers & 20 non smokers were recruited & their peripheral blood was taken for the comet assay to look for Olive moment & Tail moment to quantitatively assess the DNA damage due to cigarette smoking. Results: In our study there was no significant difference in the analysis of DNA damage (with regard to tail moment & olive moment) in smokers versus non smokers (P value: more than 0.05). Conclusions: Though smoking is known to cause DNA damage, we did not find significant differences between the two groups probably due to other multifactorial etiologies for genotoxicity.


2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 388-388
Author(s):  
Bhavina D O Batukbhai ◽  
Joseph M. Herman ◽  
Marianna Zahurak ◽  
Daniel A. Laheru ◽  
Dung T. Le ◽  
...  

388 Background: There is limited data of survival following distal pancreatectomy and adjuvant therapy in patients with distal pancreatic adenocarcinoma. This study aimed to evaluate the survival following combined modality (chemo-radiation and chemotherapy) compared to chemotherapy alone following distal pancreatectomy (DP). Methods: Patients who underwent DP for adenocarcinoma of the body or tail of the pancreas between the years 2000 and 2015 at Johns Hopkins were included. Comparison analysis was performed between patients who received combined modality versus chemotherapy alone. Kaplan- Meier curve was used to estimate the median overall survival (OS) and the disease free survival (DFS) at 1, 3 and 5 years after pancreatectomy. Results: A total of 294 patients underwent DP at our institution. Patients were excluded if adjuvant therapy was not administered, developed metastasis prior to adjuvant therapy, had stage IV disease at the time of surgery, received neoadjuvant therapy or had inadequate follow up at our institution to assess survival outcomes. We included a total of 105 patients, of which 45 patients received chemotherapy alone and 60 patients received combined modality. The two groups were similar with respect to nodal and margin status. Patients treated with combined modality had larger > 3cm tumors (p = 0.02). Median OS with combined modality was 60.6 mo and 50.2 mo with chemotherapy only. DFS was 15.2 mo with combined modality and 17.6 mo with chemotherapy only. There was no significant difference between the groups for OS (p = 0.73) or DFS (p = 0.495). Further analysis showed a trend away from chemoradiation in the recent years. Thirty patients (29%) received multi-agent chemotherapy in the adjuvant setting. A tumor diameter > 3cm was a predictive factor for receiving chemoradiation (chi-square p value 0.02). Conclusions: There is no difference in survival with combined modality compared to chemotherapy alone as adjuvant therapy following DP. All patients in this study received adjuvant therapy. We report a higher survival than previously described which could suggest a different biology for distal tumors.


2017 ◽  
Vol 5 (1) ◽  
pp. 281
Author(s):  
Amandeep Singh ◽  
Gurdhian Singh ◽  
Darsshan Singh Sidhu ◽  
Mohit Bhalla

Background: An abscess is a common surgical condition. Abscesses may occur anywhere in the body. Surgical treatment of subcutaneous and soft tissue abscesses includes percutaneous aspiration, incision and drainage without primary closure, incision and drainage with primary closure with drain. The present study was planned to compare conventional method of incision and drainage with incision and drainage with primary closure in cases of acute -abscesses.Methods: A total of 100 patients with acute abscesses were included in the study and randomized into 2 groups with 50 patients in each group. The present study was carried out to compare the conventional method of incision and drainage with incision and drainage with primary closure of the wounds in acute abscesses with regards to wound healing, post- operative pain, duration of hospital stays and recurrence rates.Results: Wound healing was significantly faster in incision and drainage with primary closure (9.18±0.941days) as compared to conventional method of incision and drainage (16.66±1.944 days) [p <0.05]. Mean hospital stay with convention method of incision and drainage was 7.12±0.718 days and with primary closure was 4.0±0.728days (p <0.05). Mean VAS was significantly less in primary closure as compared with conventional method. Decreasing trend in VAS was observed on day 3, day 5 and day 7 (p value 0.000). Recurrence rate of an abscess was seen in 5 cases in conventional method and 2 cases in primary closure (p >0.05).Conclusions: Author have observed a significant difference noted in time taken for wound healing, postoperative pain, hospital stay and recurrence rate between two groups.


2019 ◽  
Vol 5 (1) ◽  
pp. 41
Author(s):  
Anny Thuraidah ◽  
Misbawati Misbawati ◽  
Nurlailah Nurlailah ◽  
Haitami Haitami

The kidneys are organs of the body that function to regulate water balance in the body, the concentration of electrolytes in the blood and acid-base balance and secretion of waste material. If the kidney fails to function, the patient will need immediate treatment and even undergo hemodialysis (HD) therapy. A critical indicator in determining whether a person with impaired kidney function requires HD therapy is to know the creatinine level. The study aimed to ascertain the differences in creatinine levels pre and post HD also study the relationship between the age, gender, duration and frequency of HD therapy of respondents with the decrease of creatinine levels pre and post. Type of research detailed survey with a cross-sectional design. The sample was taken using a total sampling technique of 35 respondents from H BadaruddinKasimHospitalin Tanjung with a sample examination technique using the Jaffe method. The examination results of creatinine levels average for pre and post hemodialysis was11,36 and 5,58 mg/dl, which decreased 51%. The analysis statistically used Paired T-Test has a p-value = 0,000, indicating a significant difference for creatinine levels pre and post HD. Relationship between Age, Gender, Duration, and Frequency of HD Therapy with the decrease of creatinine levels pre and post HD was analyzed with Spearmen correlation and had p values more than 0,05. It means there was no relation between them. Conclusion there were significant differences in creatinine levels reduction pre and post HD while the relationship between the four of respondent characteristics to the magnitude of creatinine reduction show that there was no significant relationship.


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