The main objective of this study is to analyze the prescribing pattern of medicine in outpatient departments of tertiary care centre in Kathmandu using World Health Organization (WHO) drug use prescribing indicators. As per WHO consideration, 100 prescriptions were taken from each outpatient departments (OPD) of Nepal medical college including Orthopedics, Obstetrics and Gynecology, Surgery, Medicine, Ophthalmology, Otorhinolaryngology, Pediatrics, Dermatology and Psychiatry. Analysis of variance (ANOVA) was used to assess the statistical significance between means between all departments. Among a total of 900, 47.7% were male and 52.3% were female. Average medicine per prescription was 2.43±0.039. Number of Medicines by generic name 76 (3.4%), antibiotics 416 (19.0%), Injection 34 (1.5%), from Essential Medicine List (EML) 1,312 (60.1%), Fixed Dose Combination (FDC) 468 (21.4%) and the polypharmacy (≥4) was 129 (14.3%). The average cost was NPR 404.72±19.3 (3.69$; 1$=109.41NPR) and duration of treatment was 16.43±0.73 days. Patient’s age had positive correlation with number of medicines (p=0.002) and negative correlation with antibiotics (p=0.988). Cost of treatment had positive correlation with number of medicines (p=0.00), EML (p=0.00), duration of treatment (p=0.00) and antibiotics (p=0.33). Average medicines, from EML, and antibiotic use were high in Otorhinolaryngology with statistical significance of difference between mean. Prescription with FDC and intravenous were significantly high in Obstetrics and Gynecology. Cost and treatment duration were significantly high in Psychiatry. Tertiary healthcares need to develop and implement specific guidelines for prescriptions writing and also should develop a system to record them.
Smoking is a leading risk factor for early death and disability worldwide. Medical students and physicians are the ideal persons to educate patients about hazards of smoking. Today’s medical students will play a prominent role in future to prevent and control tobacco use. Still, the problem of smoking among the medical students is common worldwide but the pattern and extent of the problem varies from place to place. Aim of this study was to find out prevalence of smoking among medical students, factors contributing to their smoking habits, their exposure to passive smoking and to know about their knowledge about smoking related health problems. This is a cross sectional study, conducted among all first and second year MBBS students during July-September 2018. Self administered questionnaire were given to all the participants and collected after it was filled up. One hundred seventy four students participated in the study. Prevalence of smoking was 5.2% and all the students who smoked were male. The most important cause for initiation of smoking was peer pressure (56%). The average cigarettes smoked was seven sticks per day. Though 80% students knew about hazards of passive smoking, almost half of them were exposed to passive smoking. In our study we found that most of the students do not counsel their patients regarding hazards of smoking and only few participants were found to advise and encourage their patients to quit smoking.
Introduction: Gestational diabetes mellitus is increasing globally leading to significant maternal and foetal morbidity. This study aimed to find out the prevalence of gestational diabetes mellitus among pregnant women delivering in a tertiary care hospital. Methods: A descriptive cross-sectional study on a total of 3034 pregnant women was conducted in a tertiary care hospital from 14th April 2017 to 13th April 2018 with ethical approval from Research and Institutional Review Committee (Reference number: 061-077/078) of the hospital. Pregnant women who met the eligibility criteria were included in the study. Convenience sampling was done. Data were analysed using the Statistical Package for the Social Sciences version 24.0 and Microsoft Excel. Point estimate at 99% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Among 3034 patients who delivered in the tertiary centre, the prevalence of gestational diabetes mellitus was found to be 104 (3.42%) (2.57-4.26 at 99% Confidence Interval). The majority of women were of maternal age >30 years in 69 (66.34%). Out of which 48 (46.15%) women had family history of diabetes mellitus. Thirty-eight (36.53%) patients required a caesarean section. The most common obstetric complication was polyhydramnios in 35 (35.57%). Conclusions: The prevalence of gestational diabetes was lower when compared to other studies done in similar settings. The majority of women were of higher maternal age, had family history of diabetes mellitus and were also obese.
Background Cancer is a leading cause of adult deaths globally. It has a death toll of 7,84,821 people from India in 2018 alone. Huge underlying regional and sectoral (urban-rural) variations, extending to lifestyles and variations in age-specific death rates compels assessment of the geographical and social distribution is essential to frame cancer control programmes.Methods National Family Health Survey (2015-16) data (also called the Demographic Health Survey of India) has been used for this study. Results The results of the concentration indices show an overall concentration of cancer towards the richer quintiles. For the socially deprived groups, it is concentrated among the richer quintiles, while for the socially non-deprived groups, it is concentrated among the poorer quintiles. The P80/P20 ratio for cancer incidence is 0.83. The decomposition of the concentration index shows a significant contribution from women hailing from the socially deprived groups of the population.Conclusion A comprehensive strategy to combat chronic diseases like cancer includes actions minimizing exposure to risk factors at the population level, as well as reducing the risk for individuals at the higher risk level and can aid in furnishing early, medium-term and long-term effects.
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