Anuradha Joshi

Evaluation of Hand Written and Computerized Out-Patient Prescriptions in Urban Part of Central Gujarat.

INTRODUCTION Prescription order is an important therapeutic transaction between physician and patient. A good quality prescription is an extremely important factor for minimizing errors in dispensing medication and it should be adherent to guidelines for prescription writing for benefit of the patient. AIM To evaluate frequency and type of prescription errors in outpatient prescriptions and find whether prescription writing abides with WHO standards of prescription writing. MATERIALS AND METHODS A cross-sectional observational study was conducted at Anand city. Allopathic private practitioners practising at Anand city of different specialities were included in study. Collection of prescriptions was started a month after the consent to minimize bias in prescription writing. The prescriptions were collected from local pharmacy stores of Anand city over a period of six months. Prescriptions were analysed for errors in standard information, according to WHO guide to good prescribing. STATISTICAL ANALYSIS Descriptive analysis was performed to estimate frequency of errors, data were expressed as numbers and percentage. RESULTS Total 749 (549 handwritten and 200 computerised) prescriptions were collected. Abundant omission errors were identified in handwritten prescriptions e.g., OPD number was mentioned in 6.19%, patients age was mentioned in 25.50%, gender in 17.30%, address in 9.29% and weight of patient mentioned in 11.29%, while in drug items only 2.97% drugs were prescribed by generic name. Route and Dosage form was mentioned in 77.35%-78.15%, dose mentioned in 47.25%, unit in 13.91%, regimens were mentioned in 72.93% while signa (direction for drug use) in 62.35%. Total 4384 errors out of 549 handwritten prescriptions and 501 errors out of 200 computerized prescriptions were found in clinicians and patient details. While in drug item details, total number of errors identified were 5015 and 621 in handwritten and computerized prescriptions respectively. CONCLUSION As compared to handwritten prescriptions, computerized prescriptions appeared to be associated with relatively lower rates of error. Since out-patient prescription errors are abundant and often occur in handwritten prescriptions, prescribers need to adapt themselves to computerized prescription order entry in their daily practice.

Effect of female sex hormones on cardiorespiratory parameters

Introduction: Female sex hormones, estrogen and progesterone regulate various phases of the menstrual cycle. Hormonal changes tend to affect various parameters of physical fitness. Maximum oxygen uptake (VO2 max) is a measure of aerobic power. This study was planned to assess effect of different phases of menstrual cycle on cardiorespiratory parameters like pulse rate, respiratory rate and VO2 max. Methods: 100 female medical students in the age group of 17-22 years were studied for three consecutive menstrual cycles. Weight, resting pulse rate, respiratory rate and VO2 max were measured during premenstrual phase (20th-25th day) and postmenstrual phase (5th to 10th day). Results: It was observed that there was a significant increase in body weight, pulse rate, and respiratory rate during premenstrual phase. There was a decrease in VO2 max during the premenstrual phase. Conclusion: This study indicates that there is decreased cardio-respiratory efficiency during premenstrual phase.

Evaluation of out-patient prescriptions in rural part of central Gujarat

Background: The prescription error is a failure in the prescription writing process leading to wrong instructions about the identity of the recipient, the identity of the drug, the formulation, dose, route, timing, frequency, and duration of administration. This study is an effort directed to find errors in prescription writing and interventions to improve on such error-prone practices of prescription writing. Methods: This was a cross-sectional, observational study conducted to analyze the prescription writing errors in the outpatient department in the rural area of Anand district of Central Gujarat. Prescriptions were collected from two nearby rural areas of Anand city-Petlad and Anklav. The prescription copies so-obtained were analyzed as per the WHO guidelines for “Prescription Writing Errors.” Results: Overall, 191 prescriptions were collected from both rural areas in the study. The highest number of prescriptions was collected from general practitioners, followed by surgeons and gynecologists. Name, qualification, and address of prescribers were mentioned in all the prescriptions while registration number was mentioned only in 14.10% of prescriptions. The esoteric symbol was mentioned in 63% of prescriptions. Prescribers signed their prescription only in 48% of prescriptions. A total of 420 drugs were prescribed to the patients in the study. All but one drug were prescribed by brand name. Dosage form and route of administration of drugs were mentioned in >60% of drugs. Conclusion: Most medical schools provide some training in prescribing to medical undergraduates; however, this training is perceived to be suboptimal by medical students and junior doctors. Such training programs are the need of the hour.

Evaluation of perceived stress in bus drivers of Pune city

Background: Occupational stress has an aversive affect on individuals and organizations. Stress leads to physical and mental ill-health. Bus driving is a classic example of high-strain occupation. In a metropolitan city like Pune, drivers have responsibility to overcome traffic congestion and to get passengers safely and comfortably in scheduled time to the desired destination. Stress in bus drivers leads to absenteeism, substance abuse, decreased productivity, and increased accident rates. Stress detection will help in taking measures for stress reduction. Thus, this study was planned to assess perceived stress in Pune Mahanagar Parivahan Mahamandal Ltd (PMPML) bus drivers of Pune city. Aims and Objectives: To study and compare perceived stress score using Perceived Stress Scale (PSS) in PMPML bus drivers and office staff. Materials and Methods: This was a cross-sectional observational study. Study group (n = 130) included PMPML bus drivers and control group (n = 130) included volunteers from office staff of general population. In both the groups, PSS score was estimated with the help of PSS questionnaire. Data were analyzed by Student’s t-test. Results: Statistically significant increase in PSS score was observed in the study group. Conclusions: It is evident from the study that PSS score was very high in bus drivers as compared to office staff. This indicates that bus driving is a tremendously stressful job, and effective measures should be taken to reduce stress in bus drivers.

Cardiovascular drug fun cricket: Students’ perception on an innovative active teaching–learning method in pharmacology -

Background: Modern teaching trends in medical education exhibit paradigm shift from conventional classroom teaching to nonconventional teaching aids. Continuous efforts are required to incorporate innovative teaching–learning methods in curriculum to make learning interesting and interactive for students. Aims and Objective: Determine students’ perception toward an innovative, active teaching–learning method and its effect on learning. Materials and Methods: An intervention study conducted with second-year MBBS students (n = 77) after approval from institutional ethics committee. Test group (n = 44) was taught cardiovascular pharmacology by innovative way while control group (n = 33) was taught the same topic by conventional way. Knowledge of both groups was assessed by pre and post tests of objective type while perceptions of test group toward the innovative way were documented on Likert scale by semi-structured questionnaire. A pre-activity opinion was taken to know about perceptions toward conventional pharmacology teaching from all the students. Paired and independent t-tests were applied for statistical analysis of data. Result: There was no statistically significant difference in performance of pre- and posttest scores between the groups (p > 0.05). Students’ perceptions in the pre-activity questionnaire feedback revealed that more than 60% of students found teaching of pharmacology monotonous and not fostering active learning. About 70% students felt the need for active teaching–learning modules that can generate interest in subject. Post-activity feedback revealed that majority of students (about 66%) had enjoyed the new learning process and found it to be more engaging, interesting, and interactive. Conclusion: Students need to be actively engaged while learning and faculty should explore novel teaching practices that help in maintaining students’ interest.

Effect of Abstinence on Audio-Visual Reaction Time in Chronic Smokers Pursuing a Professional Course

INTRODUCTION It has now been proven that tobacco abuse is the leading cause for various carcinomas such as oral, lung and oesophageal. It also leads to atherosclerosis of major vessels, development of hypertension, autoimmune disorders, COPD, bronchitis, asthma, bronchiectasis, etc. Most smokers are dependent on nicotine and abstinence from smoking results in tobacco withdrawal and craving. It also affects cognitive skills and reaction time. Many students in professional college have the habit of smoking. In spite of awareness programmes carried out in schools, colleges and having ban on smoking, prevalence of smoking is rising in India. AIM To observe the effect of abstinence on audiovisual reaction time and to note the cause for reverting to smoking by the students pursing professional course. MATERIALS AND METHODS Sixty male volunteers in the age group of 18-25 years participated in the study. The volunteers were divided in to two groups (control group and study group). Cigarette smokers consuming at least 10-19 cigarettes per day for more than 2-3 years were included as subjects in study group. The study was conducted using a audiovisual reaction time apparatus in a quiet and bright lit room. All volunteers were subjected to baseline readings after demonstrating working of the apparatus. Auditory (high pitched and low pitched sound) and visual (red light and green light) reaction time was recorded. Thirty students in study group were subjected to these tests immediately after smoking and after 12 hours of abstinence. After all the individuals were tested, the recorded values were compared by Students t-test. RESULTS Statistically significant difference was recorded in auditory and visual reaction time in study group subjects immediately after smoking and after 12 hours of abstinence as compared to base line readings. CONCLUSION It was observed that auditory and visual reaction time was prolonged in chronic smokers after 12 hours of abstinence.