scholarly journals Outcome of Stone Fragmentation with Pneumatic and Ultrasonic Lithotripter During Percutaneous Nephrolithotomy

2020 ◽  
Vol 23 (2) ◽  
pp. 129-135
Author(s):  
Shariful Islam Khan ◽  
Md Nurul Hooda ◽  
Md Safiul Alam Babul ◽  
Mohammad Habibur Rahman ◽  
Anup Roy Chowdhury ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Percutaneous Nephrolithotomy ◽  
P Value ◽  
Pneumatic Lithotripsy ◽  
Stone Fragmentation ◽  
Study Results ◽  
Wide Range ◽  
Ultrasonic Lithotripsy ◽  
Group A ◽  
Group B

Background of the study: Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for kidney stones larger than 2 cm. PCNL has replaced open surgical removal of large or complex calculi at the most institutions. The success of PCNL is related to the ability to achieve an optimum access tract and proper fragmentation. A wide range of lithotripsy techniques are currently available. One of these is ultrasonic lithotripsy, in which the stones are fragmented and sucked out simultaneously. This technique induces minimal tissue injury and could be considered as a standard modality for PCNL. The pneumatic lithotripter uses pneumatic ballast, which crushes the stones without producing any thermal effects. Because this mechanical energy passes along the metal wire to the stone, the probe works like a chisel on the stone surface. This modality destroys all stones, regardless of their composition. There were very few studies had been done in this context in our country, so I had decided to do this study to compare the outcome of stone fragmentation with pneumatic and ultrasonic lithotripter during percutaneous nephrolithotomy. Objective: To compare the outcome of stone fragmentation with pneumatic and ultrasonic lithotripter during percutaneous nephrolithotomy. Materials & Methods: This Prospective Interventional Study (Quasi Experimental Trial) was performed in Department of Urology, National Institute of Kidney Diseases and Urology, Sher-E- Bangla Nagar, Dhaka during the period from December 2014 to May 2016. A total of 60 subjects will be selected with renal calculi (as per inclusion & exclusion criteria), among these, half of the patients will be group A (using pneumatic lithotripsy) & rest of the patients will be group B (using ultrasonic lithotripsy). The study subjects were underwent PCNL under general anesthesia, half of which used pneumatic lithotripter and rest used ultrasonic lithotripter for stone fragmentation. Above mentioned outcome variables were assessed both per-operative and post-operatively. Data were collected, processed & analyzed. Statistical analysis of relevant variables was done by unpaired Student’s T test and Chi Square test. P value Â0.05 was considered significant. Results: Total 60 patients were selected for study according to the selection criteria. Of the 60 subjects, 30 patients, those who were done PCNL by pneumatic lithotripsy were labeled as Group A and 30 patients, those who were done PCNL by ultrasonic lithotripsy, were labeled with Group B. Distribution of respondents in terms of different parameters is shown in tabulated form and statistical analysis was done in both groups to see statistical significance, p value less than 0.05 was considered significant. The mean stone fragmentation time was 27.23±4.78 (18-38) min in PCNL by pneumatic lithotripsy and those were 23.80±5.30 (13-34) min in by ultrasonic lithotripsy which is statistically significant. Other variables of interest which includes stone clearance rate, post operative haematuria and post operative hospital stay, were not statistically significant. Conclusion: Comparing the findings of the present study, results indicate that stone fragmentation time is lesser in ultrasonic lithotripsy than pneumatic lithotripsy in PCNL which decreases the overall operative time. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.129-135

scholarly journals Outcome of Lower Ureteric Stone Fragmentation by Laser in Comparison with Pneumatic Lithotripsy

2020 ◽  
Vol 23 (2) ◽  
pp. 169-175
Author(s):  
SA Anowar Ul Quadir ◽  
Khan Nazrul Islam ◽  
Md Mostafizur Rahman ◽  
Md Shafiqul Alam Chowdhury ◽  
SM Mahbub Alam
Keyword(s):  
Laser Lithotripsy ◽  
Medical College Hospital ◽  
Ureteric Stone ◽  
College Hospital ◽  
Operation Theatre ◽  
Medical College ◽  
Pneumatic Lithotripsy ◽  
Stone Fragmentation ◽  
Group A ◽  
Group B

Background: Several different modalities are available for ureteral stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet (Ho: YAG) lithotripsy have supportive outcomes. Aims: To see the outcome of lower ureteric stone fragmentation by laser in comparison with pneumatic lithotripsy. Methods: The prospective clinical study was conducted during the period from July 2012 to June 2014 in Dhaka Medical College Hospital. From the patient admitted in Dhaka medical college hospital a total of 60 patient were selected using purposive sampling methods. Selected patients were numbered chronologically and odd number group as group A (laser lithotripsy) and even number group B (pneumatic lithtripsy). Cystoscopy followed by ureterescopy with the help of guide wire was done and stone fragmentation done by either laser lithotripsy (done in general operation theatre in Dhaka Medical College Hospital) or pneumatic lithotripsy (done in Urology operation theatre in Dhaka Medical College Hospital). Collected data were processed and analyzed using computer software SPSS (statistical package for social science), version-18. Un-pair t-test, chisquare test and Fishers Exact probability test were used to analyze the data. The findings of the study showed age and sex are almost identically distributed in both groups. Results: The mean age of group A and group- B were 35.63±11.66 and 38.90±11.21 years respectively. A male predominance was observed in both groups with 70% male in group- A and 53.3% in group-B. Stone size was also observed identically in both groups. 43% of stone are larger than 10mm in group- A and 47% stone are larger than 10mm. None of other baseline variable found very between groups. Immediate stone clearance was much higher in group-A (96.7%) then that in group- B (80%). Although both the groups demonstrated 100% clearance after 1 month. Immediate complications were higher in group B then those of group- A. Ureteral perforation in group B was found 6.7% as opposed to none in group-A. Fever in group A (6.7%) was observed to be more than 3 times higher than in group- B (23.3%). Comparison of complications after 1 and 3 months shows some differences (higher in group-B) but that is not significant. Ureteral stricture developed in 3 patients in group- B compared to nil in group- A. More than 90% of patients of group-A were released from the hospital within 3 days after operation, in contrast about 40% in group-B left the hospital within 3 days. Conclusion: So, laser lithotripsy is better option for the management of lower ureteric stone by using semi rigid ureteroscope, in term of stone migration, rate of stone fragmentation and clearance, operation time, hospital stay and complication. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.169-175

scholarly journals COMPARISON OF SAFETY AND EFFICACY OF PNEUMATIC VERSUS LASER LITHOTRIPSY IN URETERIC STONES

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Ata ur Rehman Rana ◽  
Syed Atif Hussain Rana ◽  
Muhammad Saddiq Haris ◽  
Kizar Hayat Gondal ◽  
Ali Shandar Durrani ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Laser Lithotripsy ◽  
P Value ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Safety And Efficacy ◽  
Pneumatic Lithotripsy ◽  
The Past ◽  
Group A ◽  
Group B

BACKGROUND & OBJECTIVE: Treatments for ureteral calculi evolve, over the past decades from open ureterolithotomy to minimally invasive procedures. Objective of this study is to compare the efficacy of pneumatic versus laser lithotripsy in ureteric stones. METHODOLGY: A RCT study was conducted in Department of Urology Sir Ganga Ram Hospital, Lahore from 1st March 2018 to 31st August 2018. Patients were divided into two groups. In group A, 2 Fr pneumatic probe was used for pneumatic lithotripsy, while in group B, 550 μm fiber probe was used for laser lithotripsy. RESULTS: Efficacy of Group A (pneumatic lithotripsy) was seen in 57 (77.63%) patients while in Group B (laser lithotripsy) was seen in 71 (93.42%) patients with p-value of 0.006 CONCLUSION: Laser lithotripsy in ureteric stones is better as compared to pneumatic lithotripsy.  

scholarly journals PROGNOSIS OF ACUTE INFERIOR WALL MI;

2017 ◽  
Vol 24 (03) ◽  
pp. 398-402
Author(s):  
Naeem Asghar ◽  
Hafiz Muhammad Faiq Ilyas ◽  
Touseef Anwar
Keyword(s):  
Hospital Mortality ◽  
Atrioventricular Block ◽  
P Value ◽  
Inferior Wall ◽  
Av Block ◽  
Study Results ◽  
Group A ◽  
Acute Mi ◽  
Group B

Introduction: Atrioventricular (AV) block is a common complication of acuteMyocardial Infarction (MI). In pre-thrombolytic era, high (second or third degree) AV blockwas seen in approximately 5-7% of patients presenting with acute MI. In setting of Inferior MI,this was even as high as 28%. Although, the advent of thrombolytic therapy has substantiallydecreased the mortality associated with acute MI, the incidence of AV block, particularly in thesetting of inferior MI, remains high. AV block in the setting of inferior MI is also associated withhigh in-hospital mortality, however, its effect on long-term mortality is uncertain. Objectives: Tocompare the in-hospital mortality of acute inferior wall myocardial infarction with and withoutcomplete Atrioventricular block. Settings: Department of Cardiology Faisalabad Institute ofCardiology, Faisalabad. Duration of Study: Six months From: 01-05-2014 to 30-11-2014. StudyDesign: Cohort study. Results: In our study, out of 80 cases(40 in each group) 42.5%(n=17)in Group-A and 37.5%(n=15) in Group-B were between 20-50 years of age while 57.5%(n=23)in Group-A and 62.5%(n=25) in Group-B were between 51-70 years of age, mean+sd wascalculated as 52.58+9.83 and 55.43+8.06 years respectively, 40%(n=16) in Group-A and47.5%(n=19) in Group-B were male while 60%(n=24) in Group-A and 52.5%(n=21) inGroup-B were females, comparison of in-hospital mortality in both groups was done showing32.5%(n=13) in Group-A and 7.5%(n=3) while 67.5%(n=27) in Group-A and 92.5%(n=37) hadno findings of in-hospital mortality, Relative Risk was calculated as 4.33 while P value:0.005.Conclusion: We concluded that in-hospital mortality is significantly high in acute inferior wallmyocardial infarction complicated by atrioventricular block.

scholarly journals Comparison of tubeless versus tubed percutaneous nephrolithotomy

2018 ◽  
Vol 8 (1) ◽  
pp. 24-31
Author(s):  
Rajiv Shah ◽  
Nirmal Lamichhane ◽  
Sudeep Raj K.C.
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Renal Calculi ◽  
P Value ◽  
Transfusion Rate ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Tubeless Pcnl ◽  
Post Operative Complications

Percutaneous nephrolithotomy (PCNL) is an effective treatment for large renal calculi and usually a nephrostomy tube is placed in the kidney at the end of procedure to avoid post operative complications. This is to compare the outcome of tubeless PCNL versus tubed PCNL. In a randomized prospective study of sixty-four consecutive patients were enrolled and divided into two groups; A being tubeless group and B being nephrostomy group with 32 patients in each arm divided by quota sampling restricted block method with allocation ratio of 1:1. The mean age in group A was 36.69 ± 13.65 years and in group B was 38.09 ± 13.18 years with no significant p value (p = 0.501). Duration of hospital stay in group A was 3.63 ± 1.04 days and in group B was 6.34 ± 1.71 days with a significant p value (p = 0.001). In group A 31 (96.9%) and in group B 24 (75%) cases were not transfused with blood while 1 (3.1%) and 8 (25%) cases were transfused with blood with a significant p value (p = 0.026). The post operative complications were comparable in between two groups. Therefore tubeless PCNL reduces the hospital stay and blood transfusion rate with no obvious post operative complications.

scholarly journals Comparative Study Between Holmium: Yag Laser and Pneumatic Lithotripsy in the Management of Upper Ureteric Stone

2020 ◽  
Vol 22 (2) ◽  
pp. 160-165
Author(s):  
Md Ashif Chowdhury ◽  
Md Shahidul Islam ◽  
SM Shameem Waheed ◽  
Md Abdur Rakib ◽  
Faruk Hossain ◽  
...  
Keyword(s):  
Clearance Rate ◽  
Ureteric Stone ◽  
Yag Laser ◽  
Stone Clearance ◽  
Pneumatic Lithotripsy ◽  
Proximal Migration ◽  
Intracorporeal Lithotripsy ◽  
Wide Range ◽  
Group A ◽  
Group B

Background:Among various intracorporeal lithotripters, Pneumatic lithotriptorhas become the widely used tool for the treatment of ureteric stones. Recently the Holmium:YAG laser has been used with a wide range of potential urological applications, including intracorporeal lithotripsy of ureteric stones. Objective: To compare the treatment of upper ureteric stone between laser and pneumatic lithotripsy. Materials and methods: One hundred patients with upper ureteric stone who underwent ureteroscopic lithotripsy in the Department of Urology, CMH, Dhakafrom October 2012 to September 2015 were enrolled in this study. Patients were divided into two groups. Group A (LL) were treated with holmium: YAG laser and Group B (PL) were treated with pneumatic lithotripsy. Two procedures were compared in term of stone fragmentation, stone clearance rate, duration of lithotripsy, complications and duration of post operativehospital stay. Patients were monitored as outpatients after one month and after three months with a kidney ureter and bladder radiograph and ultrasonograph. Patients with migrated fragments or incomplete clearance underwent an auxiliary procedure such as Extra Corporeal shock wave lithotripsy (ESWL). Results: Mean stone size was 1.36 ± 0.36 cm in group A (LL) and 1.37± 0.36 cm in group B (PL). The immediate stone clearance rate was significantly higher inGroup A (94.0%) than Group B (76.0%). Fragments proximal migration were 6.0% in LL group and 24.0% in PL group. Use of stone retrieval equipments (baskets, forceps) was 16.0% and 64.0% in LL and PL group respectively (p<0.05) and stone fragments clearance requiring auxiliary procedures were 6% and 24% (p<0.05) in LL and PL group respectively. The mean lithotripsy time 40.46 ± 19.25 min and 36.86 ± 14.83 min and mean period of post operative hospital stay was 2.32 ± 1.22 days and 2.44 ± 1.18 days in the LL and PL group respectively. Periprocedural complications like hemorrhage, mucosal disruption/ perforation were almost same in both groups. Conclusion: In this study stone clearance and fragmentation of stone in Holmium:YAG assisted ureteroscopy was significantly higher than pneumatic lithotripsy group. The need for auxiliary procedure like ESWL for proximally migrated fragments was significantly less inHolmium:YAG assisted ureterocopy compared with pneumatic lithotripsy. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.160-165

Use of Amplatz Sheath in Percutaneous Nephrolithotomy and effect of its various sizes: Randomized Controlled Trial

2020 ◽  
Author(s):  
Adnan Siddiq
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Controlled Trial ◽  
Renal Stones ◽  
P Value ◽  
Common Source ◽  
Stone Size ◽  
Group A ◽  
Group B ◽  
Hemoglobin Drop

Background: Nephrostomy tract itself is the most common source of hemorrhage during percutaneous nephrolithotomy, which can be avoided by puncturing through the calyx with minimal angulation between calyceal system and the nephroscope shaft. Smaller the sheath diameter, lesser would be the bleeding. Our objective was to compare mean change in hemoglobin (HB) level in patients undergoing percutaneous nephrolithotomy (PCNL) with 24 versus 30 French Amplatz sheath. Methods: In this study, 142 patients were randomly divided into Group A undergoing procedure with 24 French Amplatz sheath; and Group B with 30 French sheath. At the end of procedure in both groups, nephrostomy tube was kept for 24 hours. On first post-operative day, patients’ HB was checked and compared with pre-operative data, along with blood transfusion rates. SPSS 20 was used for data analysis and p-value < 0.05 was considered significant. Results: Median age and interquartile range of Group-A and Group-B patients was (40; 18) and (41; 21) years respectively. While stone size of Group-A and Group-B patients reported as (2.0; 0.60) and (2.1; 0.70) cm. The operative time and interquartile ratio of Group-A and Group-B patients was (75; 45) and (85; 45) minutes and we found significant change in HB of Group-A (0.90; 0.80) with Group-B patients (1.90; 0.70) gm/dl respectively [p = 0.000]. Conclusion: It was observed that use of 24 French Amplatz sheath lead to less renal hemorrhage and less hemoglobin drop compared to standard 30 French Amplatz sheath. Thus, small size Amplatz sheath in percutaneous nephrolithotomy may be considered effective and safe option for treatment of renal stones.

Comparison of Endoscopic Versus Percutaneous Approach (Blind) to Control the Obturator Jerk in Patients Undergoing Transurethral Resection of Bladder Tumors Under Spinal Anesthesia

2020 ◽  
Vol 21 (2) ◽  
pp. 120-126
Author(s):  
Alamgir Md ◽  
Karim Km Monwarul ◽  
Nandy SP ◽  
Md Monwar Ul Haque ◽  
Sakhawat Mahmud Khan
Keyword(s):  
Statistical Analysis ◽  
Spinal Anesthesia ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Complete Resection ◽  
Satisfaction Level ◽  
Bladder Tumors ◽  
Percutaneous Approach ◽  
Group A ◽  
Group B

Objective: The aim of the study was to compare the endoscopic versus percutaneous approach (blind) to control the obturator jerk in patients undergoing transurethral resection of bladder tumors under spinal anesthesia. Materials and methods: A prospective observational study was performed in Department of Urology, Chittagong Medical College, Chittagong and some Private Hospitals (Ltd.) in Chittagong city during the period from January 2016 to June 2016. Total 100 patients were grouped into two, on alternate basis. Fifty(50) patients in group- A conducted with endoscopic infiltration with 20ml of injection 2% lignocaine at the bladder tumor base and another 50 patients in group-B, conducted with blind percutaneous technique with same drug and volume ( 20ml inj.2% lignocaine) to control obturator jerk. Severity of obturator jerk in both procedure, percentage of complete resection, ONB procedure related time, ONB procedure related complications and surgeon’s satisfaction level were recorded and compared between two approaches. Chi-square analysis was performed to compare the ease of approach and outcome of the two techniques. A value of P<0.05 was considered statistically significant. Results: The mean age of the patients were 59.44+7.681. In group-A, 50 patients were given inj. 2% lignocaine endoscopically at the bladder tumor base to control obturator jerk. Twenty five patients (50%) had no jerk, 20 patients(40%) developed mild jerk and 5 patients (10%) developed moderate jerk and no patients developed severe jerk. Second attempt was taken in moderate jerk patients (5 patients) and succeeded in 3(6%) patients. So, in this group, complete resection of bladder tumor was possible in 96%. In group B, complete resection of bladder tumor was possible in 84%. Statistical analysis was done and result is significant in case of endoscopic procedure to control obturator jerk(p<0.05). ONB Procedure related time was <20 mins. in 32(64%) patients in group-A and 45 (90%) patients in group- B. 20 mins. or more time was required for 18 (36%) patients in group-A and 5 (10%) patients in group-B. Statistical analysis was done and result is significant in percutaneous (blind) technique (p<0.05). ONB procedure related complications in group-A and Group –B were noted. Statistical analysis was done and result is insignificant (p>0.05). Surgeons satisfaction level were recorded on the basis of obturator jerk block and complete resection and which was statistically significant in favour of endoscopy group (p<0.05). Conclusion: It is concluded that endoscopic injection of 2% lignocaine into the bladder tumor base is better in case of jerk elimination and complete resection than blind percutaneous approach. Though, ONB procedure related time was significantly less in percutaneous group. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.120-126

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

CONVENTIONAL VERSUS THREE-DIMENSIONAL CONFORMAL EXTERNAL RADIOTHERAPY IN CANCER CERVIX: A COMPARATIVE STUDY FOR COMPLIANCE, RESPONSE AND TOXICITY

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Richa Gupta ◽  
Piyush Kumar ◽  
D. P. Singh ◽  
Arvind Kumar Chauhan ◽  
Kamal Sahni
Keyword(s):  
Clinical Response ◽  
Three Dimensional ◽  
Common Side Effect ◽  
P Value ◽  
High Dose ◽  
Cancer Cervix ◽  
Conventional Radiotherapy ◽  
Radiation Fields ◽  
Group A ◽  
Group B

INTRODUCTION: Cervical cancer is the second most frequent cancer among Indian women. Radiotherapy is the cornerstone of treatment in all its stages. Three-dimensional conformal radiotherapy (3DCRT) combines multiple radiation fields to deliver precise dose of radiation to the affected area. Tailoring each of the radiation fields to focus on the tumor delivers a high dose of radiation to the tumor and avoids nearby healthy tissue. The present study is done to compare conventional radiotherapy versus 3DCRT in cancer cervix for compliance, clinical response and toxicity. MATERIAL AND METHODS: Fifty patients were enrolled and randomised into two radiotherapy plans with radical intent - Group A treated by conventional radiotherapy and group B treated by 3DCRT. Concurrent cisplatin was delivered on weekly (35mg/m2) or tri-weekly (75mg/m2) basis during external beam Radiotherapy and was followed by High Dose Radiotherapy Brachytherapy. Clinical response and complication assessment were evaluated.Collected data was analyzed using standard statistical methods and softwares to calculate level of significance using “p” value by chi square test. RESULTS: In this study mean age of the patients was 48 years (26-67 years). The anemia was the most common side effect seen in both groups (96% vs 88%, p=0.29). Neutropenia was more in group B (36% vs 44%, p= 0.56). Lower GI toxicity was seen only in patients in group A (20% vs 0%, p=0.018). In follow up there were no significant early rectal and bladder reactions in both groups and 2 patients in each group had late rectal reactions of grade I and II (p= 0.312). No significant skin, bladder and small intestinal toxicity were seen in both groups. CONCLUSION: Conventional radiotherapy gives equally efficacious response though accompanied by toxicities which were acceptable.

scholarly journals Integration of a Virtual Dispensing Simulator “MyDispense” in an Experiential Education Program to Prepare Students for Community Introductory Pharmacy Practice Experience

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 48
Author(s):  
Ashley E. Johnson ◽  
Jillian Barrack ◽  
Jill M. Fitzgerald ◽  
Diana M. Sobieraj ◽  
Lisa M. Holle
Keyword(s):  
Community Pharmacy ◽  
Experiential Education ◽  
Self Care ◽  
Pharmacy Practice ◽  
Pharmacy Education ◽  
P Value ◽  
Community Practice ◽  
Practice Experience ◽  
Group A ◽  
Group B

Background: Technology is increasingly used to enhance pharmacy education. We sought to evaluate student learning and preparedness for community introductory pharmacy practice experiences (IPPEs) after implementation of “MyDispense” into experiential education. Methods: Both first-year pharmacy students and assigned community IPPE preceptors were eligible. Students were stratified based on previous community pharmacy experience (< or ≥ 50 h), then randomized to complete MyDispense exercises before IPPE (group A) or after 24–32 h of IPPE (group B). We evaluated preceptors’ assessment of student readiness using a 6-item Likert scale survey and students’ readiness and opinion of MyDispense using an anonymous 9-item survey. Descriptive statistics were used to characterize data. The Mann–Whitney U test was used to compare groups and a p-value < 0.05 was considered statistically significant. Results: Of 177 eligible students, 155 were randomized and 56 completed study. Group A included 32 students; 56.3% had prior community practice experience. Group B included 24 students; 50% had prior community practice experience. Forty-eight preceptors were enrolled. Students who completed exercises before rotation received higher preceptor scores for patient counseling of self-care and of medications (p < 0.05 for both). Students self-assessed their counseling skills lower than all other skills; 30.4% and 42.9% of students felt mostly or always prepared to counsel for self-care and medications, respectively. Students found MyDispense straightforward, realistic, and appreciated the ability to practice in a safe, electronic, community pharmacy, patient-care environment. Conclusion: Simulation-based software, such as MyDispense, can enhance learner understanding of the prescription fill and counseling process in a community pharmacy practice setting.

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