Introduction: Drug utilization research is an important tool to facilitate rational use of drugs. In low income countries irrational use of drugs is a common problem like overuse of drugs and inappropriate use of antibiotics, leading to poor treatment outcome and increased burden of treatment. This study was conducted to provide understanding of drug utilization pattern by using WHO Core Prescribing Indicator. Methods: This study was conducted in Orthopedics and Obstetrics / Gynecology departments. Patients visiting these Out Patient Departments with at least one drug on prescription form were included in the study. Further, information related to WHO Core Prescribing Indicators were collected in pre-designed proforma. Results: Average number of drugs prescribed per prescription was 2.6. Means of number of drugs prescribed in Orthopedics and Obstetrics / Gynecology departments were 2.9 and 2.3 respectively (p < 0.001). Drugs prescribed in generic name and from essential drug list was 41.4% and 34.3% respectively. Prescription forms with generic name in Orthopedics department were significantly more compared to Obstetrics / Gynecology department (p = 0.00002). However, there was an increased tendency to prescribe drugs from essential drug list in Obstetrics / Gynecology department compared to Orthopedics department (p < 0.001). Conclusion: Drugs were prescribed by generic name and from essential drug list, but this was not sufficient to meet the ideal values of WHO Core Prescribing Indicator. Therefore, prioritization on prescribing drugs by generic name and from essential drug list by respective departments to achieve the standards of WHO needs to be encouraged.
Introduction: Poisoning is a significant global public health problem. The appropriate management of poisoning at emergency needs accurate assessment and immediate treatment. The immense chance for better outcomes occurs with early diagnosis and treatment. This study was conducted to assess pattern, management, and outcome of poisoning in tertiary care hospital. Methods: An observational cross-sectional study was conducted in which records of patients with a diagnosis of poisoning over a period of four years were reviewed. Results: A total of 138 patients were included in the study. A majority (63%) of them were females. Most (67.4%) were managed by general or supportive measure only. Gastric lavage was done in 60% of total patients while 52.9% patients received activated charcoal. Pralidoxime and atropine was received by 51.1% of patients treated with specific antidote. All the antidotes were administered through intravenous route. Regarding outcome, 89.9% were completely recovered. Suicidal poisoning was significantly higher in married as compared to unmarried patients (p = 0.029). Similarly, there was a significant relationship between occupation of the patients and manner of poisoning (p = 0.003). Outcome of treatment had a significant association with the manner of poisoning (p < 0.001). Further analysis revealed that the patients who expired in the hospital were more likely to ingest poison accidentally. Conclusion: Suicidal poisoning is common and females are more susceptible. Insecticide and rodenticide are the commonly ingested poisons. Treatment outcome of poisoning cases is generally favorable.
Introduction: Assessing anti-diabetic drug use patterns in hospitals is an important activity which helps to promote the rational use of drugs and may suggest measures to change prescribing habits for the better. This study aimed to find the use of combination therapy in diabetes mellitus patients attending the outpatient department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among 201 diabetes mellitus patients in the internal medicine department from 2 March 2022 to 30 June 2022 for a duration of four months after approval from the Institutional Review Committee (Protocol No: IRC-LMC-01/R-022). Diabetic patients prescribed at least one anti-diabetic drug in prescription forms were included. Socio-demographic profiles, clinical characteristics and anti-diabetic drug use pattern-related data were collected. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 201 patients, 134 (66.66%) (60.14-73.18, 95% Confidence Interval) patients were given combination therapy. The most common combination therapy was metformin 500 mg and sitagliptin 50 mg. A total of 324 anti-diabetic drugs were used. The average number of drugs prescribed per patient was 1.6±0.7. The number of anti-diabetic drugs prescribed by generic name and from the national essential drugs list was 74 (22.83%) and 188 (58.02%) respectively. Biguanides were used in 176 (87.56%) patients. Conclusions: These findings were similar to some other studies conducted in similar settings. In most patients, combination drug therapy was more prevalent. Among combination therapy, two drug combinations were more prevalent.
Introduction: Height determination by measuring various body parts is of value in medicolegal investigations as well as in anthropology. The current study was conducted to analyze interrelation between foot dimensions and stature, and to predict stature from foot dimensions. Methods: The study was done in medical students where stature, foot length, and foot breadth were quantified using standard instruments. We calculated correlations between variables with correlation test and predicted stature from foot length and foot breadth using linear regression. Results: The correlation between foot length and stature, and foot breadth and stature were statistically significant in both gender (p < 0.05). Greater correlation coefficient between foot length and stature than that for foot breadth and stature indicated stronger correlation between foot length and stature. Separate formulae were drawn for calculation of stature from foot breadth and foot length by regression analysis. Conclusion: Both foot breadth and foot length were correlated with stature. Foot length was found to be a better predictor of stature.
Introduction: Subtle or gross structural changes of scalp, skull and its contents due to application of direct or indirect external force are known as head injuries. Head being the most vulnerable and prominent part of body, injuries to it cause major mortality and morbidity globally. This study focussed to find the pattern of traumatic head injuries in patients presented to Lumbini Medical College Teaching Hospital, Palpa, Nepal. Methods: The data was collected from 252 patients (164 males and 88 females) with head injuries attending Emergency or out-patient department of Neurosurgery of the institute. All patients with traumatic head injuries (scalp injury, skull fracture, intracranial haemorrhage and brain injury) were included in the study and brought dead patients and patients with non-traumatic brain lesions were excluded. Results: Among the various modes of head injuries, the most frequent was road traffic accidents accounting 125 (49.60%) cases and fall from height 108 (42.86%) cases was second to it followed by physical assault 12 (4.76%) and others 7(2.78%). Manner of injuries were unintentional in 238 (94.44%) of cases. Among males, intentional injuries were present in 5 (2.98%) cases and among females, 9 (10.72%) cases presented with intentional injuries. In 105 (41.67%) of the cases, head injuries were associated with injuries to the other body parts as well. Conclusion: The most common cause of head injury was found to be road traffic accident followed by fall from height. Intentional injuries were more common in females when compared to males.
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