Browsing by Author "Tuladhar, LR"
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Publication Efficacy of Salbutamol in Mixed Obstructive and Restrictive Pattern Spirometry(Kathmandu University, 2017) Tuladhar, LR; Tamrakar, (Tuladhar) ETABSTRACT Background Salbutamol is a short acting β2 agonist bronchodilator most commonly used for management of asthma and chronic obstructive pulmonary disease. Besides the disease state, it is also used for bronchodilator reversibility in spirometry. The spirometry reading show one of the four patterns i.e. normal, obstructive, restrictive and combined or mixed (obstructive-restrictive). Objective To determine the efficacy of salbutamol in mixed obstructive and restrictive pattern spirometry. Method A descriptive cross sectional study was conducted at Nepal Medical College and Teaching Hospital (NMCTH) for a period of 9 months. A total of 70 patients who presented with symptoms of respiratory disease in medicine outpatient department (OPD) in which spirometry was performed were selected. Of the 70 patients, 35 with mixed pattern spirometry were selected as cases and remaining 35 with normal spirometry were selected as control. After taking informed consent, spirometry parameter were measured before and after salbutamol therapy. Data was collected from medicine department, pulmonary function test (PFT) unit. All the data were entered in statistical package for social sciences (SPSS version 20) and Forced expiratory volume in first second (FEV1), Forced vital capacity (FVC), FEV1/FVC and Peak expiratory flow rate (PEFR) were analyzed. Result There was significant difference (p<0.05) in spirometry parameters (i.e. FEV1, FVC, PEFR) when after salbutamol therapy was compared from before therapy. Statistical significance was also seen in percentage change in spirometry parameter (i.e. %FEV1 change, %FVC change, % change in ratio of FEV1/FVC and %PEFR change) between case and control groups. Conclusion Salbutamol is an effective bronchodilator in mixed pattern or combined obstructive- restrictive lung disease. KEY WORDS Bronchodilation, mixed obstructive and restrictive lung pattern, salbutamol, spirometryPublication Prescription writing skills of preclinical medical and dental students in a medical college(Institute of Medicine, 2017) Shrestha, D; Thapa, R; Gurung, RS; Tuladhar, LR; Shrestha, LAbstract Introduction: Prescription is a clinician’s written order to dispense drugs. Prescription writing is one of the basic competencies to be learned by medical and dental students, who are more prone to make prescription errors during the early stages of their training. Methods: It was across sectional study conducted in NMCTH, Jorpati, Kathmandu. Medical and dental students in the first and second year were included in the study. Students were given common clinical conditions to write prescriptions. Prescriptions were analyzed for physician and drug related components. Results: The total number of medical and dental students that participated in this study was 326. The percentage of different physician related components in the prescriptions of first year medical students ranged from 61.4 to 100%, from 74.1 to 100% in second year medical students, from 55 to 100% in first year dental students and from 66.7 to 100% in second year dental students. The percentage of different drug related components of prescriptions was from 73.7% to 90% in first year medical students, from 79.3 to 94.8% in second year medical students, from 57.5 to 80% in first year dental students and from 74.1 to 92.6% in second year dental students. Conclusion: Prescription writing skills of preclinical medical and dental students are lacking in its various components. Evaluation of their prescription writing skill should be done frequently to find out the deficiencies which must be corrected by better training to reduce prescription errors and to increase adherence to improve rational prescribing. Keywords: prescription skills, medical students, dental students