BackgroundTo promote rational prescribing and appropriate use of drugs, it is important to evaluate the prescription pattern using the World Health Organization (WHO) drug use indicators. The aim of this study was to evaluate the prescription patterns and rational prescribing at the private community pharmacies of Biratnagar, Eastern Nepal, using some of the WHO core drug use indicators. Material and MethodsFive private community pharmacies were selected using systemic random sampling. Nine hundred patient encounters from these pharmacies were assessed prospectively for four months from September 2015-December 2015. Data was collected from each patient encounter and were recorded directly into a prescription indicator form. Results Average number of drugs prescribed per encounter was 2.14 (n=1930). Percentage of drugs prescribed by generic name and from essential drug list was 45.18% (n=872) and 76.11% (n=1469) respectively. Percentage of encounters in which antibiotic and injection was prescribed were 40.44% (n=364) and 3.44% (n=31) respectively. Conclusion Prescribing practices in Eastern Nepal are not up to the standards recommended by WHO. Drug use evaluation can help to ensure whether the antibiotics are appropriately prescribed or not. Poly-pharmacy, excessive use of antibiotics was quite common and concept of generic prescribing and National Essential Medicine List (NEML) was not appreciable. Standard guidelines should be recommended and strictly followed by the prescribers and National Formulary and NEML should be made available in every health institution. Physicians should be emphasized to prescribe medicines from NEML.

Background: The burden of substance abuse amongst the youths has increased worldwide including Nepal. There is limited data on prevalence of substance abuse among the adolescents. Hence this study aims to determine the prevalence of substance abuse amongst the adolescents of Dharan, Eastern Nepal.Methods: A cross-sectional study was conducted from July 2018 to December 2018. Self-administered structured questionnaire adapted from National Youth Survey sponsored by the Centre for Substance Abuse Prevention was used for data collection from 1125 higher secondary school students. Data was cleaned in Microsoft Excel and analysed using SPSS version 11.5.Results: Prevalence of ever users of tobacco were 46.04% of which the current users were 20.46%, ever users of alcohol were 37.58% of which 15.20% were current users and ever users of drug was 18.19% of which 18.13% were current users. The average age of initiating tobacco, alcohol and drugs were 14.21 ± 3.51, 15.13 ± 7.43 and 14.32 ± 4.41 years respectively. More than half of the drug users (50.71%) used cannabis and the most common reason for using any substance was peer pressure (91.64%). More than one-third (39.5%) purchased any of these substance from local shops. Conclusions: The study reported significant proportion of adolescents involved in substance abuse. The findings of this study may be beneficial for revising/ updating action plans on prevention and control of substance abuse in Nepal.Keywords: Adolescents; alcohol; drug; substance abuse; tobacco.

Introduction: To ensure safe, effective and rational prescribing by tomorrow’s doctors it is important to assess the prescribing skills of today’s medical students. The aim of this study was to assess the prescribing skills of MBBS preclinical students of a Teaching Hospital.Methods: First and second year medical students were given different sets of common clinical scenarios and asked to write a prescription for these. The physician and drug related components were analyzed following the WHO guidelines. The data were statistically analyzed using Chi-square test for 99% and 99.99% Confidence Intervals. P values < 0.01 and < 0.0001 were considered significant respectively. Results: MBBS first year student scored 123 (82%) and 94 (62.66%) in physician and drug related component respectively. MBBS second year students scored 139 (92.66%) and 111 (73.33%) in physician and drug related components respectively. Results obtained from the element prescriber's address and telephone number, date of prescription and patient’s address on the prescription of first year and second year medical students were highly significant (p<0.0001). Conclusions: Prescribing skill of first and second year MBBS students is not satisfactory. Prescribing deficiencies were found on both the physician and drug related components which emphasizes the need of adequate prescribing knowledge in order to minimize the prescription errors and irrational prescribing. Based on this study, we suggest all the undergraduate medical students should be regularly trained and evaluated to further help minimize the prescribing errors.Keywords: prescription; prescription errors; prescribing skill. | PubMed

Introduction: Self-medication practice is the use of medication without prescription of health care professionals. Drug resistance, drug side effects, wastage of resources, and serious health hazards including death are associated with self-medication. We conducted this study to find out the prevalence of self- medication among the peri-urban population of two randomly selected communities of Dharan, Nepal. Methods: A descriptive cross-sectional study was conducted among people residing in two randomly selected wards of peri-urban areas of Dharan from November 2017 and April 2018 after obtaining ethical clearance (IRC/1030/017). A pretested, structured self-administered questionnaire was used for data collection. Data were collected and entered in Statistical Package for the Social Sciences version 11.5; point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 426 respondents, the overall prevalence of self-medication was 312 (73.23%) at 95% Confidence Interval (67.83-78.63%). It was more common among female 158 (78.60%). Common symptoms were headache 201 (64.42%), fever 135 (43.26%), gastrointestinal 93 (29.8%) and respiratory illness 87 (27.88%). Analgesics and antipyretics 275 (88.14%) were the most common drugs self- medicated with. Seeking opinion from pharmacist 112 (35.89%) was the commonest method adopted to procure drugs and comfort 127 (40.7%) and time constraints 122 (39.1%) were the commonest reasons. Conclusions: Prevalence of self-medication among the peri-urban population was similar to other studies. Headache and fever was the common symptoms for which self-medication were adopted. Awareness regarding potential dangers of self-medication and different drug side effects are recommended at the community level.

Introduction Post operative wound infection continues to be the major concern even after the appropriate antibiotic coverage.Objective To find out the incidence of post operative wound infection following the use of antibiotics in clean contaminated head and neck surgery in a tertiary care centre in Eastern Nepal.Methodology It is a prospective study conducted at Department of Otorhinolaryngology and Head and Neck Surgery, Nobel Medical  College Teaching Hospital, Biratnagar from 14th April 2013 to 12th April 2015. Patient who underwent clean contaminated head and neck surgery were followed up on 1st, 3rd and 6th post–operative day (POD) and wounds were inspected for any signs of wound infection.Results A total of 144 patients undergoing various clean contaminated head and neck surgeries were included in this study. Tonsillectomy was the commonest surgery performed (40.27%). An overall wound infection rate was 11.80%. Serous discharge rd from the surgical site observed on 3rd post operative day was the most common presentation of wound infection (29.41%). Parotidectomy was the surgery presenting with highest rate of wound infection (31.25%).Conclusion This study concludes that even the best technique and appropriate antibiotic has not completely eliminated the problem of wound infection in clean contaminated head and neck surgery.Birat Journal of Health Sciences 2016 1(1): 51-55