Background: In order to improve the prescription quality and promoting rational prescription pattern, there is an obligatory need to investigate the factors that affect doctors' prescription patterns. The study was conducted to observe the antibiotics prescribing pattern at outpatient department of a tertiary medical college hospital. Methods: This was a descriptive cross sectional study in a tertiary medical college hospital during the period of January 2018 to June 2018 which was conducted on 300 prescriptions collected from different outpatient department. Results: Average number of drugs prescribed per encounter was 3.70 (Optimal value 1.6–1.8). Antibiotics (Oral, injectable and topical) were prescribed 46% (Optimal value 20.0–26.8%) and antibiotic as only injected form 19.71% (Optimal value 13.4–24.1% of total injectable drug). Drugs prescribed from the Essential Drugs List( EDL) equated to 52.90% (Optimal value 100%). The antibiotics given in most of the patients ( 91%) were without doing culture sensitivity test before prescribing. Out of 46% prescriptions with antibiotics, 79.9% had one antibiotic, 19.6% included two antibiotics and 0.7% had three antibiotics. Cefuroxime was the most commonly prescribed antibiotics (22.5%) followed by Azythromycin (11.6%) Cefixime (11.5%) Ciprofloxacin (10.9%) Flucloxacillin (10.9%) and Metronidazole (8.7%). Conclusion: This study revealed that percentage of antibiotic was high and most of the antibiotic was given without culture and sensitivity. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 36-39
Background: Bangladesh, A country with scintillating beauty of nature burdened with a dense population. Along with infectious diseases, tropical diseases are also prevalent here with a higher trend of non- communicable diseases as a result of industrialization. Practicing and prescribing as a doctor is a quite challenging profession here particularly when to deal with vast rural populations in a low resource facility. Medical education system is well developed in Bangladesh which follows traditional curriculum of teaching learning. Students are not accustomed with problem-based learning as it does not exist in curriculum. In order to confront with diverse disease pattern and overloaded population in this arduous backdrop of Bangladesh, problem- based learning can be a very effective tool for preparing medical students as an efficient, self- directed and insightful prescriber. This study was a primary step to introduce problem- based learning (PBL) to medical students of Bangladesh to evaluate the effectiveness of PBL in context of Bangladesh. Methods: Around 117 students of 4th year from 6 different medical colleges were randomly assigned for this study. Among them, half of the students attended PBL session for three days on a topic of Pharmacology and other students participated traditional lecture class. Following classes, odds ratio of performance was determined. MCQ, SAQ and total scores of assessment were compared. Comparison of scores was also done between male and female students of PBL group. Results: PBL students performed better than the LBL students. Odds ratio of their assessment performance was 252.08; with 95% confidence interval and lower range 53.89 and upper range 1179.28. The odds ratio showed strong association between PBL and student performance in Bangladesh context. Mean of total score was 30.7 ± 4.3 in PBL group and 17.2 ± 4.8 in LBL group. Total score was significantly higher (p= 0.000) in PBL group. Mean SAQ score in PBL and LBL group was 17.2 ± 2.2 and 5.3 ± 1.9 respectively which was extremely significant (p= 0.000). MCQ score mean was 13.4 ± 3.4 in PBL group versus 11.8 ± 3.7 in LBL group which was significantly higher in PBL group (p= 0.02). Among PBL group, total score and SAQ score was significantly higher in female students over male students. Conclusion: Significant findings of this study revealed PBL as an effective tool in Bangladesh context. Thereby, it is recommended from this study to take approaches for further study and initiative to incorporate PBL in curriculum as well. Bangladesh Journal of Medical Education Vol.12(1) 2021: 22-31
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
Background: Pain is an inevitable part of the postoperative experience. Current study was designed to assess the pattern of analgesic use, the adequacy of post operative pain control by documenting pain scores and patient satisfaction by documenting the pain perception score of the postoperative patients 48 hours after surgery. Materials and methods: This was a formative research and includes a mix of descriptive cross-sectional study carried out in the Department of Gynecology and Obstetrics, General Surgery and Orthopedics Surgery of Chattagram Maa-O-Shishu Hospital Medical College (CMOSHMC) during the month of January, 2018 to July, 2019. Results: A total of 180 patients underwent surgery were included in this study. Baseline data were collected both retrospectively and prospectively. Only analgesic used immediately after operation in three departments were Pethidine (100%). Diclofenac sodium suppository were used in appendectomy and cesarean section (50/60, 83%) and (26/60, 43%) respectively. Mostly, Diclofenac Sodium IV (55/60, 91%) was used in lower limb surgery. The maximum pain score were 5.3 (SD=2.3), 5.6 (SD =1.9), and 6.1 (SD =1.3) during coughing in the first 8 hour and minimum pain score 2.4 (SD =1.0), 2.2 (SD = 0.8) and 1.7 (SD=1.3) at rest 48 hours after cesarean section, appendectomy and lower limb surgery respectively. But pain score eventually increased during coughing 48 hours after surgery. After 48 hours of surgery maximum pain perception score 3.9 (SD = 0.9) in lower limb surgery and minimum perception score were 3.5 (SD =1.8) in cesarean section. Majority of the appendectomy patient (76%) satisfied with pain management where as only 43% satisfied in case of cesarean section. Conclusion: This study enabled the researchers to get a precise picture of the current state of POPM in different hospitals, as well as identify particular needs for improving such practices in health care facilities and implementing an educational intervention in order to improve the post operative pain management. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 69-73
Proper doctor-patient communication produces therapeutic benefit on the patient. The arts and tips of communication skill can change the feelings of a patient forever. Good communication skill should have verbal, non-verbal and para-verbal components. Unfortunately, many postgraduate doctors of our country cannot satisfy the demand of their patients due to lack of training on communication skills. In this paper, a model for communication skill training has been proposed for newly graduated doctors which includes formal lecture, video demonstration, role play and evaluation by creating different scenarios. The selected time for communication skill training would be the time gap between publication of result of final professional MBBS and starting the internship training. With increasing demand of creating more communicative physicians, implementation and further recommendations on communication skill training for new graduates are encouraged.Bangladesh Journal of Medical Education Vol.9(2) 2018: 32-36
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