Browsing by Author "Joshi, M"
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Publication An overview of over the counter drugs in pregnancy and lactation(Kathmandu University, 2006) Das, BP; Joshi, M; Pant, CROver the counter (OTC) drugs are commonly used by pregnant women. Most OTC drugs are safe in pregnancy but some have unproven safety and may adversely affect the growing foetus. The safety profile of some of the medication may change according to the gestational age of the foetus. Because an estimated 10% or more of the birth defects results from maternal drug exposure, the US Food and Drug Administration (FDA) has assigned a risk category to each drugs. Among the commonly used OTC drugs Acetaminophen, Chlorpheniramine, Kaolin and Pectin preparations and most antacids have a good safety record. The drugs like H2 blockers; Pseudoephedrine and Atropine/ Diphenoxylate should be used with caution. The risk and benefit while using OTC drugs in pregnancy has to be assessed. Key words: OTC drugs, Pregnancy, LactationPublication Developing tool and Measuring Integration Characteristics of Basic Science Curriculum to Improve Curriculum Integration(Kathmandu University, 2018) Maharjan, BR; Bhandary, S; Upadhyay, S; Ghimire, S; Shrestha, I; Joshi, M; Vaidya, S; Pradhan, PABSTRACT Background Integrated curriculum enhances students’ learning and the retention of knowledge. At Patan Academy of Health Sciences, integrated organ system based curriculum is used with Problem Based Learning as the principle teaching learning method to foster students’ learning. In addition, other approaches of integration were under taken such as integrated assessment; logical arrangement teaching learning methods (lectures and practicals); joint effort of faculty in curriculum planning and delivery; conducive environment to foster hidden curriculum. This study describes the perception of faculty and students on integration characteristics of Basic Science curriculum. Objective To measure the integration characteristics of Basic Science Curriculum. Method Tool was developed to measure integration characteristics of Basic Science Curriculum and ensure whether such planned integration has been achieved. Mixed method was used to measure the perception of the integration characteristics i) quantitatively by questionnaire survey to faculty and students ii) qualitatively by in-depth interview of students. Result Both faculty and students perceived that all the blocks in Basic Science was well integrated in the quantitative questionnaire survey. But, in the in-depth interview, students perceived integration of curriculum in organ system blocks were better integrated compared to Principle of Human Biology blocks where fundamentals of basic science disciplines were delivered. Students reflected that Problem Based Learning not only integrated Basic Science disciplines but also with clinical sciences and the social context. But, students perceived that Community Health Sciences curriculum was not so well integrated with Basic Science subjects. Conclusion Overall, this study showed that planned integration in Basic Science curriculum was successfully executed during curriculum implementation. KEY WORDS Basic Science, Integration characteristic, Integrated curriculum, PBLPublication Knowledge, Attitude and Practice Towards Antimicrobial Resistance and Antimicrobial Adherence among Female Community Health Volunteers Before and After an Educational Intervention(Kathmandu University, 2025) Jha, N; Kafle, S; Joshi, M; Pandey, A; Koirala, P; Bhandary, S; Shankar, PRABSTRACT Background Antimicrobial resistance is a serious problem in Nepal. Knowledge, attitude, practice and adherence of female community healthcare volunteers of an intervention area about antimicrobials before and immediately after a workshop conducted on 24th February 2024 was measured. Objective To compare the knowledge, attitude and practice towards antimicrobial resistance and antimicrobial adherence among female community health volunteers. Method A questionnaire containing four sections related to various themes of antimicrobials was developed. Knowledge, Attitude and Practice questions were analyzed using two sample proportion tests. Feedback regarding the educational intervention was also obtained using a 7-item tool and open responses. Result All Female Community Health care Volunteers from Mahalaxmi municipality participated. Most participants were aged between 41-50 years [19 (42.2%)] and [25 (55.6%)] had working experience greater than 10 years. The scores for statements antimicrobial resistance are a serious problem worldwide, [84.4% vs 60% (p=0.004)] and antibiotics are used to inhibit the growth of bacteria improved post- intervention [100% vs 77.8% (p ≤ 0.001)]. Scores for attitude statements like, taking antibiotics without consulting a physician [91.1% vs 60% (p ≤ 0.001)], missing a dose or two of antibiotic treatment contribution to antibiotic resistance, [75.5% vs 46.6% (p = 0.002)] among others improved. The scores for certain practice statements also improved post-intervention. The median scores for attitude scale, [31 vs 26 (p ≤ 0.001)] and practice scale, [31 vs 34 (p = 0.011)] were different before and after the workshop. Participant feedback on the workshop was positive. Conclusion The session was effective in increasing participants’ practice scores and may lead to more rational use of antimicrobials. The attitude, practice and total scores were different before and after the workshop. KEY WORDS Antimicrobial resistance, Educational intervention, Feedback, Female community healthcare volunteersPublication Prevalence Survey of Antimicrobial Use among Admitted Patients in Tertiary Care hospital: An observational study(Kathmandu University, 2025) Aryal, S; Joshi, M; Uprety, BN; Shrestha, RK; Gupta, M; Shah, P; Rajbhandari, P; Amatya, R; Shrestha, P; Ojha, ARABSTRACT Background Monitoring the antimicrobial use is one of the key strategies to address the growing global threat of antimicrobial resistance. Objective To find out antimicrobial usage at tertiary care hospital of Lalitpur, Nepal. Result An observational cross-sectional study was carried out at the Patan Academy of Health Sciences, Lalitpur, Nepal on September 25 and 26, 2023. World Health Organization point prevalence survey methodology was used with minor modification to meet hospital’s context. The data on antimicrobial usage were collected from the medical records of patients admitted at or before 08:00 am on the day of the study in the acute care ward. Result The study involved 324 inpatients, with females comprising 176 (54.3%) and males 148(45.7%). The mean age was 37.89 years ± 24.87. Antibiotics usage was 78.1%. A total of 471 drug was prescribed of which 312 (66.2%) was used for therapeutic purpose and 159 (33.8%) for prophylaxis. Of 312 antibiotics, 283 (90.7%) were utilized empirically. Majority of prescribed medications belonged to watch group 16 (48.5%). Ceftriaxone was the most frequently prescribed antibiotic 142 (30.1%) and was the preferred choice for surgical prophylaxis 68 (94.4%). A total of 24 (72.7%) drugs were prescribed from the National List of Essential Medicines and 432 (91.7%) prescriptions were written using generic names. Conclusion The use of antibiotic was high, with good adherence to essential medicines and generic prescribing. Strengthening antimicrobial stewardship and evidence-based practices can further optimize prescribing, enhance patient safety and help combat antimicrobial resistance effectively. KEY WORDS Antibiotic, Nepal, Point prevalence survey, Tertiary care hospital