Objective: Irrational drug use increased the risk of adverse drug reactions (ADRs), the emergence of drug resistance and a leading cause of morbidity and mortality worldwide. The study was designed to analyse prescription patterns and antibiotic use among outpatients in a tertiary care teaching hospital in Bangladesh.Methods: This prospective survey was conducted among the out-patients in a district hospital. The prescribed drugs were classified according to Anatomical and Therapeutic Chemical (ATC) classification system. Patient characteristics and drug data were recorded. The prescription pattern was analysed using general drug use indicators according to World Health Organisation (WHO).Results: A total of 405 prescriptions were analyzed of which 54% of child and 46% of adult prescriptions. The age and body weight of the patients were not mentioned in 30% of child and 62% of adult prescriptions and none of the prescriptions included sex of the patients. Physician's handwriting was not clear and legible in 31% prescriptions. A total 1362 drugs were used in this study with an average 3.36 drugs per prescription. However, none of the drugs was prescribed in generic name. Children were highly exposed to antibiotics (66%) than to adults (44%) of which cephalosporin's (30%) and macrolides (14%) were commonly used. Interestingly, non-steroidal anti-inflammatory drugs (NSAIDs) were also highly accounted in children (53%) than to adults (36%). Conclusion:Our results suggested that the prescription information was incomplete and physicians did not follow the standard guideline for drug treatment resulting in polypharmacy and indiscriminate use of antimicrobials irrespective to the age of patients.
Proper postnatal development of testis is prerequisite for acquisition of full functional potential of testis. The initiation and maintenance of spermatogenesis depend on testosterone, and the production of mature sperm is highly reliant on androgen activity in the testis. The goal of the study was to investigate the effect of exogenous testosterone on testicular biometry and histomorphometry, and seminiferous epithelium in Black Bengal goat during the postnatal development. A total of 42 Black Bengal goats were divided into two categories: control and testosterone-treated; and each group again subdivided into seven groups (n=3) according to age, viz. group-I (at birth or day 0; d0), group-II (1 week of age), group-III (2 weeks), group-IV (1 month), group-V (2 months), group-VI (4 months), and group-VII (6 months). Goat kids of testosterone-treated group were injected with testosterone hormone @ 125 mg/kid (0.5 ml of Testanon™ 250 Injection, IM, 250 mg/ml, Nuvista Pharma Ltd., Bangladesh) IM weekly until the sample collection. The testicular development was slow up to 2 weeks of age, and after that, in control goats, a quick growth of the testicles was seen. In contrast, a slow trend of testicular development was continuous throughout the study period (postnatal 6 months) in testosterone-treated goats. A continuous and gradual developmental process of testis was observed in control goats. Seminiferous tubules were shown to have a marked increase in diameter at 4 months indicates initiation of spermatogenesis at this age, and completion of the first wave of spermatogenesis, i.e. establishment of spermatogenesis was observed by 6 months of age as confirmed by the presence of all types of cells of spermatogenic lineage in the seminiferous epithelium including spermatozoa were found attached to the Sertoli cells at their ad luminal border, and in the lumen of the seminiferous tubules. Continuous administration of exogenous testosterone exerted a negative effect on the postnatal developmental process of testis of Black Bengal goats. The postnatal developmental process of testis was very slow, and the proliferation of spermatogonia and lumenization of the seminiferous tubules, also known as seminiferous epithelium stratification, were not seen in testosterone-treated goats until they were 6 months old indicates delayed postnatal testicular development and disrupts spermatogenesis. J. of Sci. and Tech. Res. 4(1): 25-36, 2022
Acute coronary syndrome (ACS) is a leading cause of death among people in Bangladesh. The aim of the study was to analyze the clinical course and treatment strategies in patients with ACS and to determine to what extent management of ACS in a tertiary care general hospital in Bangladesh adhered to current guidelines. This study was carried out in the coronary care unit (CCU) of a tertiary care general hospital, Rajshahi, for a period of 3-months. A total number of 240 patients presenting with ACS were included in our study and the most common symptoms were acute chest pain (90%) and dyspnea (49%). The study group comprised of 27% female and 73% male patients with varying risk factors including hypertension (45%), hyperlipidemia (43%), family records of coronary artery disease (CAD) (20%), diabetes (17%) and smoking (15%). The most frequent ECG finding in patients was T wave change (71%), pathological Q wave (67%), ST segment elevation (33%), ST depression (9%), whereas, 12% patients with ACS reported to have normal ECG. Patients with ACS had elevated levels of SGOT and CK-MB. Troponin I level was positive in 100% of the patients with a mean peak troponin level of 1.5± 0.15ng/ml. In clinical setting, the patients were immediately managed with isosorbidedinitrate (58%), streptokinase (40%) and intravenous heparin (LMWH) followed by (46%) and (54%) of aspirin and aspirin-clopidogrel combinations respectively. In addition, long-term management with antihypertensive included -blocker (58%), calcium channel blocker (29%), ACE-I (25%) and diuretics (12%). Anti-diabetic (18%) drugs were also prescribed in patients with co-existing diabetes and CAD. Adherence to guidelines is limited by lack of funds and resources in the hospital; however, attention must be paid to improve patient outcome. The average hospital stay ranges 2-3 days and hospital mortality was 10%.
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