scholarly journals A Survey of Factors Influencing Drug Choice and the Prescribing Attitudes Among Junior Doctors of Two Major Tertiary Care Hospitals in Chittagong City

2018 ◽  
Vol 17 (1) ◽  
pp. 17-22
Author(s):  
Jannatul Ferdoush ◽  
Abhijit Chowdhury ◽  
Kohinoor Parveen ◽  
Maliha Ata ◽  
Sefa Sarwath Alam ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Complete Response ◽  
Continuous Medical Education ◽  
Junior Doctors ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Factors Influencing ◽  
Drug Choice ◽  
Tertiary Care Hospitals

Background: The magnitude of rational prescribing is well known but the irrationalities and errors in prescriptions are seen worldwide as the training of future doctors is still not up to the mark. This study aimed to find out the factors influencing drug choice and the prescribing attitudes among junior doctors of two major tertiary care hospitals in Chittagong city. Methods: A cross-sectional questionnaire survey was conducted among the junior doctors of Chittagong Medical College Hospital (CMCH) and Chattagram Maa -O- Shishu Hospital Medical College (CMOSHMC) to assess the factors influencing drug choice and the prescribing attitudes among junior doctors during August 2016. Results: The questionnaires were provided to 220 participants of whom 162 (73.63%) participants provided a complete response to the survey. The response rate was 75.89% in CMOSHMCH and 71.29% in CMCH. The majority (87.03%) of junior doctors mentioned that they are highly influenced by their supervising senior doctors’ patterns of prescriptions. About 79.01% of them took the cost of drugs into consideration while prescribing. 58.64% of the prescribers reported their confidence while prescribing without supervision. On the otherhand, 33.33% doctors mentioned that side effects of the drug changed their patterns of prescriptions. Only one-third (33.95%) of the junior doctors opined that the pharmaceutical promotional offers never influence them. Conclusion: Junior doctors decide their drug of choice mainly by copying their supervising senior doctors’ prescriptions without knowing how to choose, and they feel less confident while prescribing. Issues of drug cost, adverse drug reactions concerned the majority of the participants, but they do not have the clear ideas on how to deal with these practice behaviours. Moreover, pharmaceutical promotional offers significantly persuaded the junior doctors’ prescription patterns. So, there is a need for the continuous medical education programs in hospital settings to train the junior doctors for building capacities and competencies while prescribing. Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 17-22

scholarly journals Satisfaction of women with health service provider in outpatient department of Obstetrics and Gynecology at a Tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Ashia Khatun ◽  
Khairun Nahar ◽  
Mst Nurunnahar Aktar ◽  
Fatema Mahbooba Akter ◽  
Habibur Rahman
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hospital Environment ◽  
Obstetrics And Gynecology ◽  
Care Hospital ◽  
Health Service Provider ◽  
College Hospital ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Medical College

Background: Patient's satisfaction over the health care services is very important issue in Bangladesh.Objective: The purpose of present study was to find out the level of satisfaction of women attending in the OPD of Obstetrics and Gynecology department at a tertiary care hospital in Dhaka.Methodology: This descriptive type of cross sectional study was carried out in the OPD of Obstetrics and Gynecology department at Dhaka Medical College from September 2011 to October 2011 for a period of one month. All the women attending in Obstetrics and Gynecology department in outdoor service at Dhaka Medical College Hospital, Dhaka with the age group of 22 to 40 years were selected as study population. A purposive sampling method was used to collect the data.Results: A total number of 200 cases were taken for this study. Highly satisfied over the services delivered by the doctors was reported in 135 (65.8%) cases and service of nurses was satisfied 111(55.8%) of cases. Satisfactory waiting time (two hours) was 143(7l.9%) of cases and the satisfactory hospital environment was 127 (63.8%) of cases.Conclusion: In conclusion most of the women are satisfied to the treatment delivered by the doctors at the OPD of a tertiary care hospital.J Shaheed Suhrawardy Med Coll, 2014; 6(2):79-81

scholarly journals Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

2013 ◽  
Vol 3 (1) ◽  
pp. 29-31
Author(s):  
Swapna Bhattacharjee ◽  
Shekhar Bhattacharjee ◽  
Rukhsana Parvin
Keyword(s):  
Chronic Cough ◽  
Tertiary Care ◽  
Complete Recovery ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Cough Variant Asthma ◽  
Medical College

Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13871 J Enam Med Col 2013; 3(1): 29-31

scholarly journals Cross sectional study to assess the awareness of pharmacovigilance among post graduate residents of tertiary care medical college hospital of central India

2018 ◽  
Vol 7 (3) ◽  
pp. 386
Author(s):  
Pooja Solanki Mishra ◽  
Gopal Gudsurkar
Keyword(s):  
Graduate Student ◽  
Single Point ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Post Graduate ◽  
Global Database ◽  
Medical College ◽  
Post Graduate Student

Background: Pharmacovigilance knowledge and awareness in post graduate student doctors is key factor for proper implementation of PvPI. This study was planned to evaluate the knowledge &awareness of pharmacovigilance in post graduate students in tertiary care centre in Indore.Methods: It was a single point cross sectional questionnaire-based study conducted in a tertiary care Institute MGM Medical College & M.Y. Hospital in the state of Madhya Pradesh at Indore. It was conducted among post graduate student doctors from various clinical departments. Total of 150 questionnaires were distributed, 115 of them were returned back and were analysed.Results: Overall knowledge level was satisfactory. 91.30% knew about ADR while 95% were aware about PVPI. 13% knew about local AMC at Indore while only 4.34% knew global centre for Pharmacovigilance is at Sweden Uppsala. 86.95% thought Med watch as global database for ADR against only 13% knew its Vigibase. 96.50% thought ADR reporting is necessary. 97.40% thought it should be included in UG curriculum. 95.65% had not reported any ADR till date while 86.95% had not seen an ADR form.Conclusions: Post graduate doctors are the prime candidates to impart the importance of pharmacovigilance. The study strongly suggested that there was a great need to create awareness among the post graduate doctors to improve the reporting of ADRs.

scholarly journals Clinical evaluation of total abdominal hysterectomy - a prospective study in a tertiary care hospital

2015 ◽  
Vol 6 (2) ◽  
pp. 76-77
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Before And After ◽  
A Prospective Study

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77

Phenotypic and Genotypic Isolation of MRSA from Burn Wound Infected Patients at a Tertiary Care Hospital in Bangladesh

2020 ◽  
Vol 7 (1) ◽  
pp. 12-17
Author(s):  
Anika Tasnim ◽  
AKM Shamsuzzaman ◽  
Md Shah Alam ◽  
Jannatul Ferdose ◽  
Fazlay Akbar Khan
Keyword(s):  
Culture Media ◽  
Tertiary Care ◽  
Meca Gene ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Care Hospital ◽  
Burn Wound ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Background: Patients of burn wound are generally more susceptible to infection due to concurrent status of malnutrition and immunosuppression. Among many bacteria, MRSA has appeared as a challenging pathogen irrespective of effective antibiotic therapy. Objective: The purpose of the present study was to detect the prevalence and antibiogram of MRSA in burn wound infected patients. Methodology: The present cross sectional study was conducted at Department of Microbiology in Rajshahi Medical College, Rajshahi, Bangladesh. The samples were collected from Burn and Plastic Surgery Unit of Rajshahi Medical College Hospital, for a period of one year. Phenotypic detection of MRSA were done by cefoxitin disc diffusion method and genotype (mecA gene) was detected by PCR which was conducted at Dhaka Medical College, Dhaka among all the S. aureus isolates. Result: A total of 212 wound swabs were subjected to bacteriological culture media for isolation of MRSA and other organisms. As a whole 89.62% samples yielded growth in culture of which Pseudomonas aeruginosa was the predominant pathogen (34.18%). Out of 21 S.aureus isolates, 07(33.33%) were detected as MRSA by cefoxitin resistance and presence of mecA gene. Although over 85% MRSA were resistance to ciprofloxacin and ceftriaxone, but the present study could not detect any vancomycin resistant MRSA. Conclusion: The high prevalence and decreased sensitivity of MRSA to commonly used antibiotics has been observed in Burn Unit of RMCH. Therefore it is necessary to establish an antimicrobial surveillance system in hospital settings to prevent the spread of MRSA. Bangladesh Journal of Infectious Diseases 2020;7(1):12-17

scholarly journals Estimation of Serum Copper in Post-menopausal Women Attending in a Tertiary Care Hospital, Bangladesh

2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
N Ferdous ◽  
Farzana Akonjee Mishu ◽  
Shamsunnahar ◽  
Syed Md Tanjilul Haque ◽  
ANM Ashikur Rahman Khan ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Premenopausal Women ◽  
Serum Copper ◽  
Copper Level ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference

Background: Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients do not decrease. In fact, the needs for some micronutrients actually increase with age. The risk of nutritional disturbances mainly trace elements deficiencies is high during postmenopause causing or intensifying serious clinical symptoms. Methods: This cross sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Obstetrics and Gynecology, Mymensingh Medical College Hospital during the period from July 2013 to June 2014. A total of 100 subjects were included in this study. Among them 50 apperantly healthy postmenopausal women (Case) aged between 45-60 years were considered as case and another 50 regular menstruating premenopausal women(Control) aged between 30-40 years were selected as control. Results: The mean age of cases and control groups was 50.5±2.3 years and 36.5±4.4 years respectively. In this study we found Serum Copper levels in cases and controls were 115.36±8.836 µg /dl and 90.58 ±6.315 µg/dl respectively had (p< 0.01) significant difference. Conclusion: Serum Copper level was significantly increased in postmenopausal group in comparison to premenopausal women (p< 0.01). Estimation of serum Cu level might be incorporated in every postmenopausal woman for prevention of complications. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 110-113

scholarly journals Multimorbidity Patterns Among Hospitalized Geriatric Patients in Medicine Wards of a Tertiary Care Hospital in Dhaka City

2021 ◽  
Vol 7 (1) ◽  
pp. 56-59
Author(s):  
Sumiya Bent Kalam ◽  
Sadia Islam ◽  
Mohammad Abdullah Az Zubayer Khan ◽  
Tanjina Akhter
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College

Background: Elderly people are posing a significant health burden in our country for their multi morbidity as economic growth has increased our life expectancy. Pattern of multi morbidity of this older people varies according to geography, ethnicity, culture and life style. Aim: The aim of this study was to identify the prevalence and pattern of multi morbidity of elderly patients admitted in a tertiary care hospital. Method: 50 random cases of elderly patients aged more than 60 years admitted in medicine and allied wards of Dhaka medical college hospital were observed at this cross-sectional study from January 2017 to June 2017(total 6 months period). Data were reviewed and analyzed using simple frequency and percentage. Protocol was reviewed by institutional ethical board (IRB) of Dhaka medical college hospital. Result: A total number of 50 elderly patients with age ranging from 60 to 95 years were observed with male and female ratio 1.3:1 having multi morbidity among 92.0% patients and female is more affected than male. Hypertension, ischemic heart disease, diabetes mellitus and stroke were found most common diseases as individual. Hypertension and diabetes mellitus was found as the most common multi morbidity pattern followed by hypertension and IHD, stroke & diabetes mellitus. Conclusion: This study sheds light on priority needs of elderly patients in terms of medical facility in tertiary care hospital of Bangladesh. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 56-59

scholarly journals Re-Emargence of Susceptibility to Conventional First Line Drugs in Salmonella Typhi and Paratyphi a Isolated from Enteric Fever Patients in a Tertiary Care Hospital of Northern Bangladesh.

2017 ◽  
Vol 11 (1) ◽  
pp. 3-5
Author(s):  
Maiz Ul Ahad Suman ◽  
Md Abdullah Siddique ◽  
SM Shamsuzzaman ◽  
Abu Rayhan Khandakar
Keyword(s):  
Enteric Fever ◽  
Health Care Cost ◽  
Tertiary Care ◽  
Empirical Therapy ◽  
Salmonella Typhi ◽  
Care Hospital ◽  
First Line ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Enteric fever is endemic in Bangladesh and involves significant health care cost. The first-line drugs chloramphenicol and co-trimoxazole have not been the part of empirical therapy for decades due to development of multidrug resistant Salmonella strains. The objective of this study was to determine the antibiogram pattern of Salmonella strains isolated from the blood of clinically suspected enteric fever patients. A cross sectional study was conducted in Rajshahi Medical College Hospital & Dhaka Medical College from August 2014 to July 2015. Total 323 blood samples were collected from suspected enteric fever patients and isolation rate of Salmonella was 9.29% [S.typhi (3.41%), and S.paratyphi A (5.88%)]. Among isolated S.typhi, 9.09% were resistant to chloramphenicol, cotrimoxazole and cefixime and there were no S.typhi resistant to azithromycin and cefotaxime. Among the isolated S.paratyphi A, 5.26% were resistant to chloramphenicol, co-trimoxazole, azithromycin, cefotaxime, and cefixime. There were no ceftriaxone resistant Salmonella. Low proportion of resistance to first line antibiotics (chloramphenicol, co-trimoxazole) suggests that these drugs can be used once again. Bangladesh J Med Microbiol 2017; 11 (1): 3-5

scholarly journals Stress gradation of medical practitioners during the pandemic (covid-19) along with ways to de-stress; a cross sectional study at tertiary care hospitals using Kessler’s 10 psychological distress scale.

2021 ◽  
Vol 28 (09) ◽  
pp. 1239-1244
Author(s):  
Umair Toqueer ◽  
Muhammad Usama Zardad ◽  
Mahwish Toqueer ◽  
Anila Riyaz ◽  
Sana Khan ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Junior Doctors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Psychological Distress Scale ◽  
Tertiary Care Hospitals ◽  
Distress Scale ◽  
The Impact

Objectives: To determine stress grades of doctors working in tertiary care  hospitals by using a standard measuring tool i.e. Kessler 10 psychological distress scale along with finding out different coping methods adopted by doctors during the COVID-19 pandemic. Study Design: Cross Sectional study. Setting: Tertiary Care Hospitals of Khyber Pakhtunkhwa (KPK), Pakistan. Period: 15 March 2020 to 20 June 2020. Material & Methods: A structured questionnaire was sent online to the junior and senior doctors working during the pandemic. The data was automatically collected with the help of Google docs and then analysed using SPSS 26. Results: Of the 219 doctors who completed the questionnaire 142 were males (64.8%) and 77 were females (35.2%). Interestingly, analysis of the score revealed that 38.8% of the doctors were found likely to be well, 16.4% of the doctors were likely to have mild disease and 20.5% were likely to have a moderate disorder while 24.2% were likely to have a severe disorder. Further analysis showed that the mean of  Kessler’s score was greater for junior doctors as  compared to Consultants which was found to be statistically significant (p=0.044). Conclusion: The impact of Corona virus disease (COVID-19) on the stress levels of health workers warrants considerable attention as it was declared a pandemic. Assessing the psychological impact and ways to tackle them will not only help the health care workers during this pandemic but will be beneficial in future pandemics as well.

scholarly journals Similarities between Preexplorative Diagnosis and Perexplorative Findings of Intestinal Obstruction Patients in Two Tertiary Care Hospitals in Bangladesh

2019 ◽  
Vol 9 (3) ◽  
pp. 155-159
Author(s):  
Sonia Akter ◽  
Deb Prosad Paul ◽  
Debasish Das
Keyword(s):  
Intestinal Obstruction ◽  
Preoperative Diagnosis ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Diagnostic Tools ◽  
Age Group ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Obstructed Hernia

Background: Intestinal obstruction is a common surgical problem that surgeons face in clinical practice. Still intestinal obstruction is a major problem in medical college hospitals in Bangladesh. Causes of intestinal obstruction remain same as earlier. There is lack of statistical data in our country. So, this study will be helpful in various aspect of management of intestinal obstruction patients by providing data. Objective: To find out similarities between preoperative diagnosis with actual peroperative findings of intestinal obstruction. Materials and Methods: This cross-sectional study was conducted from April 2013 to April 2014 at Enam Medical College Hospital and Dhaka Medical College Hospital. Two hundred patients were selected by purposive sampling of diagnosed cases of intestinal obstruction. Results: Among the subjects male were 124 (62%) and female were 76 (38%). Mean age was 34.56 ± 9.13 years. The maximum respondents were from 21–30 years age group (54%) followed by 31–40 years (18%) age group. Chronic intestinal obstruction was present in 53% cases and acute intestinal obstruction in 47% cases. The clinical profile showed that all patients had abdominal pain followed by vomiting (78%). The preoperative diagnosis of intestinal obstruction was neoplastic obstruction (24%) followed by obstructed hernia (22.5%). The highest similarities (100%) were observed in case of volvulus and ileosigmoid knotting. Obstructed hernia had the highest accuracy (97.7%) followed by neoplastic obstruction (91.66%). Maximum patients (13.5%) suffered from wound infection followed by burst abdomen (3%). Conclusion: The preoperative diagnoses are very much similar to peroperative findings. The clinical parameters and other mandatory diagnostic tools commonly used in tertiary level hospitals in our country showed diagnostic accuracy in diagnosis of intestinal obstruction. J Enam Med Col 2019; 9(3): 155-159

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