Introduction: Mental illness accounts for 14% of all disability adjusted life years (DALYs) lost worldwide and is one of the major contributors to the global burden of disease. In spite of this much of burden and disability there is a huge gap between the treatment and help seeking behavior. Though, the mental illness is a common problem, due to stigma and lack of knowledge they prefer to visit alternative sources like faith healers, traditional practitioners and quacks. Very few of them seek psychiatrists help. So, this pathway to care study aims to provide some descriptive insight into the pathways to care among the psychiatric patients attending the tertiary care hospital in Kathmandu valley. Material and Method: A cross-sectional study among 66 patients seeking psychiatric outpatient services in Kist medical College, Imadole, Lalitpur, Nepal which is a Teriatry hospital from the period of 1st August – 31st October, 2018. Semi structured proforma developed by department of Psychiatry which covered the socio-demographic profile and WHO (1987) collaborative “pathway study” encounter form as a guiding tool was used to collect the data. Results: Out of 66 enrolled patients, 60.6% were in the age group of 21-40. Almost equal proportion of male (51.5%) and female (48.5%) visited psychiatric services. Majority of the patients were married (81.8%), Chhetri (25.8%) by caste and Hindu (81.8%) by religion. Majority of the patients were from outside valley (51.5), educated upto primary level (31.8%) and housewife by occupation (28.8%). The most common diagnosis was Depression (16.7%) and Alcohol Dependence syndrome (16.7%). Majority (45.5 %) of the patients had visited faith healer before visiting to Psychiatrists. 57.6 % patient visited psychiatrists within 2.5 months duration and majority of them were initiated to visit psychiatrists by family members/ relatives. Conclusion: Faith healers were the most common first contact for psychiatric patients. Despite of that majority of the patients had visited psychiatrists within 2.5 months duration. In most of the cases family members/ relatives were the one to initiate for psychiatric consultation.

Introduction: Worldwide, the morbidity of psychiatric illnesses is on the rise. Quality in-patient services are a part of quality mental health services provision. Knowledge about the pattern of illness among patients admitted to the ward could help the service providers to plan better and provide better services. This study was undertaken to explore the clinico-demographic profile of patients admitted to psychiatric ward at BPKIHS..Material And Method: This is a hospital based retrospective and cross-sectional study. After ethical approval from the Institutional Review Committee, the data of all patients admitted to Psychiatry Ward from 1st January 2007 to 31st December 2016 were collected from the data-base of Medical Records Section. The diagnoses were made according to the ICD-10 criteria. 3687 admissions were processed for the analysis.Results: Of the 3687 admissions, 2183(59.2%) were male and 1504 (40.8%) were female. The age range was 4-92 years with mean age of 32.4(±12.6) years. The majority of the admissions (62.5%) were from Sunsari (1159,31.4%) and surrounding districts (1147,31.1%). Mood disorders were the commonest diagnoses 1788(48.5%) followed by schizophrenia, schizotypal and delusional disorders 829(22.5%) and psychoactive substance use disorders 813(22.1). 92% of patients admitted were improved on discharge and three cases expired in the ward. Out of 3687 admissions, 957(26%) were readmissions.Conclusion: Mood disorders were the commonest diagnosis among the admitted patients. Outcome of hospital stay was good with 92% discharged in improved condition and only three mortalities in 10 years duration. Address seems to significantly affect the service utilization. J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017, Page: 15-21

BackgroundFixed-dose combinations (FDCs) are being widely prescribed for the treatment of various disorders in India. However, not all FDCs are rational. To know the awareness of physicians in prescribing rational FDCs was the need of the hour in order to assess the prescribing trends and rationality of FDCs. Eventually, this will help to formulate the guideline for rational use of FDCs.MethodsThis was a prospective observational study conducted in All India Institute of Medical Sciences Bhopal, MP, India. Prescriptions were collected over a period of 2 months by the convenience sampling method from hospital pharmacy. The data were subjected to descriptive analysis using Microsoft Excel and Graph Pad Prism. Results were expressed in mean ± standard deviation (SD), percentages and 95% confidence interval.ResultsA total of 2496 drugs were prescribed in 1008 prescriptions, of which 945 (37.82%) were FDCs with an average of 0.93 ± 0.94 (mean ± SD) per prescription. Of 945, 67 (7.09%) were included in National List of Essential Medicine 2015 considered as rational. The number of prescriptions containing one or more FDCs was 629 (62.40%). FDCs were more frequently prescribed to male patients (54.92%) and in the age group of 18–30 years (33.44%). FDCs containing a proton pump inhibitor were prescribed most frequently (16.29%) followed by nonsteroidal anti-inflammatory drugs (13.96%) and multivitamins (7.83%).ConclusionsPrescribing irrational FDCs was very common, and hence there is an obvious need to update our prescribers about the irrationality of FDC and motivate them to develop a habit of rational prescribing.

Background: Rational use of medicines (RUM) is highly desired worldwide yet many shortcomings are found. This study aims to evaluate prescription pattern and RUM using World Health Organisation (WHO) prescribing indicators.The impact of audit and feedback has also been studied, along with comparison with published data. Methods: A cross-sectional observational study was conducted in the outpatient department setting of a tertiary care centre in central India. Data were collected from 2719 prescriptions across different departments from hospital pharmacies from 2016 to 2018 at different time periods. The data was analysed using WHO core prescribing indicators.Results: Average number of drugs per prescription was found to be 2.53 � 1.23 (WHO optimal value ≤ 2). The mean values of prescribing indicators for antibiotics (19.82% vs. ≤ 30%) and injection prescribing (1.98% vs. ≤10%) were within optimal values. Generic prescribing (15.96% vs. 100%) and prescribing from National List of Essential Medicines (NLEM; 37.37% vs. 100%) were found to be significantly lesser. Annual audit and feedback showed improvement in generic prescribing and prescribing from NLEM, but the other trends continued to be similar. Conclusion:While use of antibiotics and injections among outpatients was found to be rational, there is scope of

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