Browsing by Author "Alam, K"
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Publication A study on rational drug prescribing and dispensing in outpatients in a tertiary care teaching hospital of Western Nepal(kathmandu University, 2006) Alam, K; Mishra, P; Prabhu, M; Shankar, PR; Palaian, S; Bhandari, RB; Bista, DObjectives: To analyze the prescriptions of out-patients for rational prescribing and dispensing and to evaluate the patient’s knowledge regarding use of drugs, using INRUD indicators. Methods: A cross-sectional, descriptive study was conducted at the Manipal Teaching Hospital, Pokhara, Nepal during the time period from June 10 th to August 19 th 2004. Results: Totally 247 prescriptions were randomly selected for analysis, wherein 720 drugs were prescribed. Only 15% of drugs were prescribed by generic name, 21.67% of the total drugs consisted of fixed-dose combinations, only 40% of drugs were from the Essential drug list of Nepal and 29.44% (n=212) were from the WHO Essential drug list. It was found that more than half (54.17 %) of the drugs were from Nepalese National Formulary and 35.69% were from WHO model formulary. Dermatological products were most commonly prescribed followed by drugs acting on central nervous system, antimicrobials and drugs acting on cardiovascular system. Among the drugs dispensed, 79.16% were oral followed by topical (18.19%) and parenteral forms (2.98%). Diagnosis was mentioned only in 3.23% (n=8) of the prescriptions and the average cost per prescription was found to be 241.11 Nepalese rupees (US$ 3.26). It was found out that pharmacist labelled only 0.4% of the medication envelopes with the name of the patient. However, 82.6% of the medication envelopes were labelled with name of the drug and 87.0 % with drug strength. Only 53.8% (n=133) of the patient knew both the duration of the therapy and administration time of drugs. Conclusion: There is a need for educational intervention for prescribers and both managerial and educational intervention for the hospital pharmacists to improve prescribing and dispensing. Key words: Rational use of drugs, Dispensing, Pharmacist, PrescribingPublication Fixed drug eruption due to co-trimoxazole: a case report(Institute of Medicine, 2006) Dwari, BC; Bajracharya, S; Gupta, S; Mishra, P; Palaian, S; Alam, K; Palaian, S; Prabhu, MAbstract Background: Cotrimoxazole is a synergistic fixed dose combination of sulfamethoxazole and trimethoprim used in treatment of several infections including urinary, respiratory, gastrointestinal tract infections. Because of its wide spectrum and low cost it is one of the most preferred antimicrobial in Nepal. Fixed drug eruptions (FDEs) are drug rashes which tend to occur at the same site in the particular patient each time when an offending drug is administered. Co-trimoxazole is a drug commonly implicated for causing FDEs. Case report: We report a case of FDE due to co-trimoxazole occurred in a patient for whom it was prescribed by a local practitioner without taking adequate medication history. We also carried out the causality, severity, preventability and predictability as well as the economic impact of the associated adverse drug reaction (ADR). The report suggests that before prescribing any drug, clinicians should take appropriate medication history and upon occurrence of any ADR the patient should be counseled and instructed to communicate with the clinicians wherever they attend for the next time. Keywords: Causality assessment, Co-trimoxazole, Fixed drug eruption, Naranjo algorithmPublication Pattern of poisoning cases in a teaching hospital in Western Nepal(Institute of Medicine, 2008) Kishore, PV; Palaian, S; Paudel, R; Mishra, D; Ojha, P; Alam, K; Mishra, PAbstract Introduction: Poisoning is a common problem in Nepal. Data from the Western region of Nepal are lacking. The present study analyzed the clinical profile and the management pattern of poisoning cases admitted to the Manipal Teaching Hospital (MTH). Methods: The poisoning cases treated at Manipal Teaching Hospital from January 2003 to June 2006 were studied. Results: A total of 98 poisoning cases (0.51% of Emergency department admissions) were treated (female 54.08 %) and age group 21-40 years (44.90 %). Nearly one third (32.65%) reached the hospital with in two hours of poison consumption. The median (interquartile range) duration of the hospital stay was 4 (2) days. The poisoning was intentional in 79.59% cases. The route of exposure was mainly oral (96.94%). Rat poison was the commonest poison (31.68%) followed by drugs (22.77%). Majority (83.67%) received symptomatic treatment. Secondary complications were observed in 28.57% and the overall fatality rate was 18.37%. Rat poison was responsible for 5 deaths. Nearly two thirds (65.31%) of the total cases received psychological counseling. Conclusion: Similar studies covering different hospitals conducted over a long period are needed to confirm our findings. Keywords: Drug over dosage, Poisoning profile, Rodenticide, Western NepalPublication Prevalence of adverse drug reactions with commonly prescribed drugs in different hospitals of Kathmandu valley(Kathmandu University, 2008) Alam, K; Palaian, SNAPublication Regarding the article “Irrational fixed dose combinations in Nepal: Need for intervention”(Kathmandu University, 2008) Poudel, A; Khanal, S; Alam, K; Palaian, SNA