NepMed Repository :: Browsing by Author "GP, Rauniar"

Browsing by Author "GP, Rauniar"

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Antimicrobial utilization pattern in out patient services of ENT department of tertiary care hospital of Eastern Nepal
(Kathmandu University, 2005) BP, Das; A, Sethi; GP, Rauniar; SK, Sharma
Objective The objective of this study was to monitor the antimicrobial utilization in ENT out patient services in a tertiary care hospital of Nepal. Materials & Methods A total of 191 prescriptions were randomly audited at varying time interval from the department of ENT in the year2003. The data was collected in customized Performa in the form of antibacterial audit questionnaires. It also contained Patient particulars, diagnosis, investigations, drug details and information from the prescriber regarding the indication for prescribing antimicrobial agent, suspecting organism underlying infection, duration of therapy and details of any concomitant medications. Results The incidence of use of antimicrobial agents (AMA) in 191 prescriptions was analyzed from the enrolled prescriptions, a total of 218 antimicrobials i.e.1.4 antimicrobial agent per patient were prescribed. .The AMAs were indicated therapeutically in 73.29% of patients & 19.37% patients for prophylaxis. The AMAs were advised for more than 72 hours for prophylaxis in 86.48%. In the concomitant medications antihistaminic were prescribed in 32.62% and NSAIDS in 21.98% cases. Most of patients reported with upper respiratory tract infections (URTI- 32.56%), Chronic Suppurative otitis Media (CSOM-18.3%), sinusitis (6.28%), tonsillitis (5.75%),. Pharyngitis (3.66%), Acute Suppurative Otitis Media (ASOM-2.61%) and others. The diagnosis was established clinically in 42.40% and confirmative in 35.60%. In 21.46% the diagnosis was not disclosed. Out of 191 patients, culture sensitivity tests were performed for only 31 patients and 13 patients depicted a positive culture sensitivity tests. The common microbes isolated from the culture were staphylococcus aureus (69.2%). Streptococcus (7.7%), Enterobacteriacae (7.7%), Pseudomonas auroginosa (7.7%) & psendomanas mirabilis (7.7%). Clinically suspected organism were mentioned in only 32 prescriptions and most prescriber presumed the infections due to staphylococci & pseudomonas (43.75%), streptococci (21.8%),Gram negative organisms (12.5%) and H influenza (9.3%).The use of a single drug was abundant (89.52%), two drugs (9.94%), and three drugs (0.52% )prescriptions. Ciprofloxacin (23.85%) was preferred, followed by amoxycillin (20.06%), combination of ampicillin + cloxacillin( 9.17%), doxycyclin (5.96%). Erythromycin (4.58%) and cotimoxazole (4.58%). Expensive drugs i.e azithromycin (2.75%), roxithromycin (1.37%) and cephalosporins (3.21%) were also prescribed. The causative microbes were sensitive to amoxycillin (53.84%), cloxacillin (53.84%) ciprofloxacin (46.15%), gentamicin (46.15%), and cephalosporin (46.15%). But resistant to erythromycin, tetracycline, cotrimoxazole and norfloxacin) Conclusions-Majority of patients were prescribed drugs irrationally with misleading indications without confirming the bacteriological culture and sensitivity. Keywords: AMAs (Antimicrobial Agents), URTI (upper respiratory tract infection), Drug utilization
Evaluation of anxiolytic activity of tensarin in mice
(Kathmandu University, 2007) GP, Rauniar; S, Deo; SK, Bhattacharya
Introduction: Anxiolytic drugs are amongst the most frequently prescribed drugs. Available anxiolytic agents are associated with several limitations. Several indigenous drugs are being evaluated but none has been proved to be effective. Objectives: Aim of the present study is to evaluate the anxiolytic effect of Tensarin. Material and method: The behavioural tests were conducted with single dose schedule and multiple seven-dose schedules of Tensarin 50mg/kg, 100mg/kg and 200mg/kg in comparison with Diazepam 1mg/kg in mice using open field test, activity-monitoring and passive avoidance test. There were eight treatment groups in each treatment schedule. Each group consisted of ten animals of either sex. The data obtained were analyzed using non- parametric test and P-value of less than 0.05 was considered to be statistically significant. Results: Multiple doses produced anxiolytic effect as indicated by an increase in rearing, number of crossing and the time spent by the animals in Central Square. It was also seen that there was significant decrease in step down latency, increase in step down error and time spent by animal in shock zone, these effects were not observed in single dose study. Conclusion: Tensarin shows a dose dependent anxiolytic effect but further studies are needed to find out the exact mechanism of action of the formulation. Key words: Tensarin, Anxiolytic activity, Open field test, Passive avoidance test.
Recent advances in the management of epilepsy: A review
(Kathmandu University, 2005) SK, Bhattacharya; GP, Rauniar; BP, Das
Epilepsy is a complex disorder affecting brain function having a variety of contributing factors. The genetic predisposition plays a key role in the genesis of epilepsy. The already existing antiepileptic drugs (AEDs) provide effective control of majority of patents with different types of seizures. In some refractory cases and in those patients who can not tolerate the conventional AEDs, there is an urgent need to provide relief by controlling the seizures adequately. Various newer approaches in the rational management of seizures have been evolved during the recent years, based on different mechanisms of action and side effects profile. A brief account of these newer treatment modalities have been incorporated in this review in order to enlighten the readers about the possible beneficial effect of this regimen vis a vis the limitations of such use. Keywords: Neurotransmitter imbalance, defective gene, newer antiepileptic drugs, plasma levels, newer approaches.
Vagus nerve stimulation: A novel approach for prevention and control of refractory seizures
(Kathmandu University, 2007) SK, Bhattacharya; BP, Das; GP, Rauniar; H, Sangraula
In order to understand the brain function and to treat various neuropsychiatric illnesses including epilepsy, continued search and discovery of newer antiepileptic drugs has failed to revolutionize the approach in the management of this complex disorder. Moreover, in close to 30% of epilepsy patients, the seizure control is either not satisfactory or it is intractable to pharmacotherapy. Amongst the non-pharmacological treatment options for refractory epilepsy, vagus nerve stimulation occupies a unique position as an adjunctive treatment in prevention and control of partial-onset seizures in adults and adolescents older than 12 years. Though the precise mode of action of VNS is still debatable an honest attempt has been mode here to review all possible literatures available on VNS to establish its role in the management of this complex disorder. Key words: Neuropsychiatric illness, Intractable Epilepsy, Vagus nerve stimulation, Seizure control

Browsing by Author "GP, Rauniar"

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