Rational use of drugs has immense impact on quality health care. Developing nations have 80% essential drug list prescription. Even though WHO estimates 15-25% antibiotics prescription in these regions, majority of Nepalese patients are prescribed more than one antibiotic in addition to inappropriate prescription in 10%-42% patients.Moreover, Nepal stands as a leading antibiotics prescribing Asian nation. Escalating irrational prescription and excessive over the counter use of antibiotics at peripheral regions of Nepal is possibly leading the emergence of multidrug resistant bacteria.Organisms like S. pneumoniae, K. pneumoniae, Salmonella spp., E. coli, N. gonorrhea, MRSA are rapidly developing first-line, second-line and multi-drug resistance in Nepal. Antimicrobial resistance is the biggest global health concern of the present day threatening the emergence of post antibiotic era. Timely intervention is must to safeguard future generation.Keywords: Antimicrobial resistance; irrational prescription; primary health care.

Problem-based learning (PBL) is a student-centered pedagogy in which students learn about a subject in the context of complex, multifaceted, and realistic problems. Working in groups, students identify what they already know, what they need to know, and how and where to access new information that may lead to resolution of the problem along with discussion of the solution within the group. Few medical schools in Nepal have already incorporated problem-based learning into their curricula and other medical schools are planning to adopt. However, when PBL is introduced into a curriculum, it has implications for staffing and learning resources and demands a different approach to timetabling, workload, and assessment. So, issues like human resources requirements and logistic requirements need to address specifically from Nepal Medical Council for the assurance quality of medical education which, in turn, has contributed in enhancing the quality of health care services in Nepal. Hence, this paper is prepared for developing further understanding about major difference between conventional method of Medical education and PBL in relation to human resources requirements and infrastructure. This article ends with some of the important recommendations that could be considered additionally to existing minimum requirements from Nepal Medical Council for the Medical Schools/ Universities in Nepal who are running or planning to implement Problem-based Learning in their curricula. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9530   NOAJ July-December 2013, Vol 3, Issue 2, 46-47

Introduction: Self-medication among adolescents has become a serious global problem that plays an important role in irrational use of medication and tends to increase with the age of adolescents. Limited research has been done in Nepal regarding antibiotic knowledge among non-medical students. Hence, this study aims to assess the knowledge of higher secondary non-science students regarding antibiotic use, resistance and its consequences. Methods: A cross-sectional descriptive study was done during antibiotic awareness week 2017 among 471 grade 11 and 12 non-science students of private schools in Kathmandu. Convenience sampling technique was used. Data was collected through self-administered questionnaires. Descriptive statistics was utilised to find out the knowledge level of the students. Results: The mean age of the students 245 (52%) male, 226 (48%) female) was 17.19 years and 335 (71.1%) were from grade 12. Approximately all 462 (98.1%) the participants had inadequate knowledge regarding antibiotic and their knowledge mean score was 5.8±2.56. More than half 277 (58.8%) of the students had not heard about antibiotic resistance, among those who have heard 113 (24%) said that doctor and nurses were the source of information. Conclusions: Almost all of the participating students lacked adequate knowledge regarding antibiotic. Thus, it is imperative to create school and community based awareness programs by policy makers for adolescents to upgrade their knowledge on safe use of antibiotics as well as to prevent the consequences of antibiotic resistance during their adult life.

Background: Drug Promotional Literatures are usually relied upon for drug promotion, however studies have shown them to contain several pitfalls. World Health Organization has time and often revised the guideline to address the issue and World Health Organization Ethical Criteria for Medicinal Drug Promotion was established. Based on this guideline, several regional as well as national guidelines have been formulated. Though laws to regulate drug promotion is existent, studies have shown problems with drug promotional literatures in Nepal also. This study was carried out to analyse the drug promotional literatures distributed by pharmaceutical companies in Nepal as per World Health Organization Ethical Criteria for Medicinal Drug Promotion.Methods: A cross-sectional study over a period of one year was conducted at our department. Pharmaceutical companies registered in Department of Drug Administration, Kathmandu and consenting for the study were requested to provide ten unique drug promotional literatures of their products. Collected drug promotional literatures were analysed for inclusion of essential information as per World Health Organization Ethical Criteria for Medicinal Drug Promotion, level of biasness. Different drug promotional literatures were also classified and compared for these aspects. Results: A total of 48 pharmaceutical companies were included in the study. Drug promotional literatures (n = 372) were analysed during the study. Adherence to criteria concerned with positive attributes of the promoted medicine was found to be higher, most of the drug promotional literatures adhered to 5-8 criteria of World Health Organization Ethical Criteria for Medicinal Drug Promotion and were categorised into grade B. Difference in adherence as well as number of biased drug promotional literatures was also seen when drug promotional literatures were compared on different basis. Conclusions: Adherence to World Health Organization Ethical Criteria for Medicinal Drug Promotion was found to vary when drug promotional literatures were classified as per pharmaceutical company, type of formulation being promoted, type of drug promotional literatures.Keywords: Drug act Nepal 1978; drug promotional literatures; WHO-ethical drug criteria for medicinal drug promotion.

Introduction: Cervical cancer ranks as the most frequent cancer among women between 15 and 44 years of age in Nepal. It is one of the preventable cancers. The effectiveness of cervical cancer screening depends to a great extent on the level of awareness. Objective: The objective of study is to explore the knowledge regarding cervical cancer and its screening and use of Pap smear test as a screening tool amongst the married women in Sankhu, Kathmandu. Methodology: A descriptive, cross-sectional study was conducted in April 2017 using interview guided questionnaire. One hundred and ten married women aged 30-60 years were included in the study to assess knowledge regarding cervical cancer and its screening. Among 110, 85 were eligible for screening tests but only 65 consented and participated in Pap smear tests. Multiple regression analysis was used to find out the association of knowledge and practice of cervical cancer and its screening with various variables. Results: Out of 110 participants, 54.5% belong to age groups 30-40 and mean age was 41.50 years. Though 62.5% knew about cervical cancer and 26.8% knew about pap smear test, only 22.7% participants had undergone cervical cancer screening test previously. Multivariateregression analysis showed that the lower education level was significantly associated with poor knowledge on cervical cancer (Odd ratio: 1.71, 95% Confidence interval 1.10-2.66; p=0.01) and poor practice of its screening (Odd ratio 1.92, 95% Confidence interval 1.27-2.89; p=0.00). Conclusion: The study reveals that education level has significant effect on knowledge and practice of screening tests.

Background: Antibiotics are considered to be among the most commonly sold drug classes globally. Antibiotic resistance is a recognized public health issue at the local, national and global levels.Objectives: The aim of this study was to identify awareness of general public regarding the use and resistance of antibiotics.Methodology: A descriptive cross-sectional study was conducted in Kathmandu in November 2016 using a quantitative questionnaire among 120 adult people aged 20–60 years. Convenience sampling method was used and information on use of antibiotics and resistance was obtained using semi-structured questionnaire through interview method. Descriptive statistics was done to describe the respondent’s level of awareness regarding use of antibiotics and resistance.Results: Among the total respondents, majority had incorrect awareness as regards to action, reasons for using antibiotics, possible side effects of the antibiotic. Seventy one percent of the respondents had not heard about antibiotic resistance. The study finding showed that about 66.7% of the participants had inadequate awareness towards use and resistance of antibiotics.Conclusion: The findings demonstrate that the overall awareness on antibiotic use and resistance is poorly understood among our respondents. This information can be utilized in future educational and antibiotic resistance awareness raising campaigns.

Forensic medicine deals with the application of medicine for the purpose of law. It is now commonly used to describe all aspects of forensic caseworks; including forensic pathology, that branch of forensic medicine which investigates death, and clinical forensic medicine, which involves interaction between the law, judiciary and the police involving (generally) living persons.The medico legal investigation system in our country still lags far behind the developed countries. The doctors doing the medico legal and post-mortem work at the district level hospitals are often untrained in this sensitive job. It is a job of great responsibility and to leave it to inexperienced doctors is actually doing injustice to the society. Forensic experts handle a very small part of total medico-legal work as most of them work in private medical colleges which are not permitted to handle the work. Mortuaries are housed in outdated facilities. Exposure to the medical students on medico legal cases including autopsy is done only on a sporadic basis taking them to nearby government hospitals and even if they visit the hospitals, inadequate infrastructure prevents better learning. Private medical colleges are conducting postgraduate course in forensic medicine without handling medico legal cases.There should be a post of forensic medicine specialist, at least at the zonal hospitals and the district hospitals handling more medico legal cases. The private medical colleges, especially those enrolling postgraduate students in the field, must seek permission to conduct medico legal works and the government also should not be reluctant in permitting so as it's not producing adequate experts in itself as per the need of the country.

Background: Periodontal disease is an inflammatory oral disease that affects the soft and hard tissues supporting the teeth. Gingivitis, an early stage, when untreated leads to periodontitis that causes progressive tooth mobility leading towards tooth loss. Periodontitis is ubiquitous and commonly manifests in adult life. Early detection of oral diseases makes them more amenable to treatment and allows better chance of cure. BDS students are young adults who are going to be future oral health care provider. Their knowledge and oral hygiene practices may impact oral health status of a society. Aims: The aim of this study was to evaluate the knowledge of oral health and periodontal disease and correlate it with oral hygiene practices among BDS students not exposed to clinical practice. Materials and Methods: This cross-sectional study was carried out among 120 students of first, second and third year BDS at Kantipur Dental College. The students who were not exposed to clinical practice were invited to participate. The data was collected by self-administered structured questionnaire. There were total of 15 questions on knowledge and oral hygiene practice and scores were assigned to each question. Data analysis was done by SPSS 20 software program. Results: The mean knowledge score of the population was 6.58 ± 1.29 and mean practice score as 6.20 ± 1.73. The participants had good knowledge (55%) of oral health and periodontal diseases. However, only 22.5% of participants followed good oral hygiene practices. There was no significant difference of knowledge between males and females (p = 0.831) but a statistically significant difference was seen in the practice of oral hygiene (p = 0.006). Conclusion: Despite having good knowledge (55%) of oral and periodontal health, 77.5% of the BDS students did not follow good oral hygiene practices on a regular basis. Dental students must be encouraged to be good role models in practicing as well as promoting oral health. The authors would like to recommend incorporating some oral health and preventive dentistry topics in the non-clinical BDS curriculum.