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Shankar PR. Academic designations for the modern age. Can Med Educ J 2023; 14:146-147. [PMID: 37719389 PMCID: PMC10500410 DOI: 10.36834/cmej.76544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Affiliation(s)
- P Ravi Shankar
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
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Thapa B, Pandey A, Gautum S, Kc S, Chhetri PD, Pokhrel E, Poudel S, Shankar PR. Clinicopathological Profile of Dengue Infection in a Tertiary Care Centre in Nepal. JOURNAL OF NEPAL HEALTH RESEARCH COUNCIL 2023; 20:859-867. [PMID: 37489668 DOI: 10.33314/jnhrc.v20i4.4172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/20/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Dengue is a mosquito-borne viral disease with a wide spectrum of presentations ranging from subclinical disease to severe dengue. Dengue is endemic to the Terai of Nepal. Interestingly, an increasing incidence has been reported from hilly areas like Kathmandu valley. This study explored the clinicopathological profile of dengue infection. METHODS A total of 84 serologically confirmed dengue cases from September to November 2019 at KIST Medical College were recruited in a cross-sectional study after obtaining ethical approval. Dengue was categorized as dengue without warning signs, dengue with warning signs, and severe dengue. Clinicopathological information was recorded in the proforma by reviewing patients' records. A descriptive statistical tool and chi-square test were carried out. RESULTS Out of 84 patients, 76% (64) were dengue without warning signs, 21.4% (18) were dengue with warning signs and 2.4% (2) were severe dengue. About 97.6% (82) presented with fever. During the course of illness, anemia was identified in 38.1% (32), thrombocytopenia in 65.5% (55), hemoconcentration in 6% (5), and leucopenia in 82.1% (69). Similarly, elevated aspartate transaminase and alanine transaminase (ALT) was observed in 67.7% (42) and 53.2% (33) respectively. The severity of dengue on presentation to hospital was significantly associated with thrombocytopenia, leucopenia, and elevated ALT. Similarly, the severity during course of illness in hospital was significantly associated with hemoconcentration, thrombocytopenia, leucopenia, and elevated ALT. CONCLUSIONS Most common presentation of dengue infection was fever. The most common laboratory abnormalities were leucopenia, thrombocytopenia, hemoconcentration, anemia, and elevated liver enzymes. Awareness of these clinical and laboratory parameters is important for the prompt diagnosis, severity estimation, and overall management of dengue infection.
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Affiliation(s)
- Bibechan Thapa
- Department of Paediatrics, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - Aakriti Pandey
- Department of Emergency Medicine, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - Santosh Gautum
- Department of Internal Medicine, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - Sajana Kc
- Department of Internal Medicine, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - Prabha Devi Chhetri
- Department of Paediatrics, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - Estory Pokhrel
- Department of Emergency Medicine, Nidan Hospital, Lalitpur, Nepal
| | - Sangeeta Poudel
- Department of Emergency Medicine, Banepa Hospital, Lalitpur, Nepal
| | - P Ravi Shankar
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
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Jha N, Thapa B, Pathak SB, Pandey A, Pokhrel S, Shankar PR, Bhandary S, Mudvari A, Dangal G. A Point Prevalence Study of the Use of Antibiotics in Six Tertiary Care Hospitals in the Kathmandu Valley, Nepal. Kathmandu Univ Med J (KUMJ) 2022; 20:351-358. [PMID: 37042379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background Point prevalence survey (PPS) on antibiotic use developed by the WHO has already been used in many hospitals globally. Objective To obtain information on antibiotic prescribtion using point prevalence survey methodology in six private hospitals in the Kathmandu valley. Method This descriptive cross-sectional study was completed during 20th July to 28th July 2021 using point prevalence survey methodology. The study was conducted among inpatients admitted at or before 8:00 AM on the day of survey in various wards. Data was presented as frequencies and percentages. Result Maximum number of patients were above 60 years [34 (18.7%)]. Number of male and female participants were equal [91 (50%)]. Only one antibiotic was used in 81 patients (44.5%) followed by two antibiotics in 71 (39%) patients. Duration of prophylactic antibiotic use was one day in 66 (63.7%) patients. Blood, urine, sputum, and wound swabs were the common samples for culture. Cultures were positive for 17 (24.7%) samples. The common organisms isolated were E. Coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. Ceftriaxone was the most used antibiotic. Drug and therapeutics, infection control committee and pharmacovigilance activities were present in 3/6 (50%) study sites. Antimicrobial stewardship was present in 3/6 (50%) and microbiological services was present in all hospitals. Antibiotic formulary and antibiotic guideline were present in 4/6 sites and facilities to audit or review surgical antibiotic prophylaxis choice in 2/6 (33.3%) sites, facility to monitor antibiotic use in 4/6 (66.6%) and cumulative antibiotic susceptibility reports in 2/6 (33.3%) study sites. Conclusion Ceftriaxone was the most used antibiotic. E. Coli, Pseudomonas aeruginosa and Klebsiella pneumonia were the commonly isolated organisms. Not all parameters for infrastructure, policy and practice and monitoring and feedback were present at the study sites. KEY WORDS.
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Affiliation(s)
- N Jha
- Department of Clinical Pharmacology and Therapeutics, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - B Thapa
- Department of Emergency Medicine, Kirtipur Hospital, Kirtipur, Nepal
| | - S B Pathak
- Department of Intensive Care Unit and Critical care, Nepal Mediciti Hospital, Sainbu, Bhaisepati, Nepal
| | - A Pandey
- Department of General Surgery, Madhyapur Hospital, Bhaktapur, Nepal
| | - S Pokhrel
- Department of Emergency Medicine, Nidan Hospital, Lalitpur, Pulchowk, Nepal
| | - P R Shankar
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
| | - S Bhandary
- Department of Community Health Sciences and School of Public Health, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal
| | - A Mudvari
- Department of Clinical Pharmacology, Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal
| | - G Dangal
- Kathmandu Model Hospital, Kathmandu, Nepal
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Rekha UV, Bhuminathan S, Shankar PR. A Comprehensive Review on Therapeutic Perspectives of Morinda citrifolia (Indian Noni) to Combat Cancer. JPRI 2021. [DOI: 10.9734/jpri/2021/v33i62a35538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Back ground: Indian Noni (Morinda citrifolia L.) is a large shrub or small evergreen tree, also known as Indian mulberry. It is a medicinal plant that has been used as conventional medicine and food additives for a long time. As a drug, plant bioactivity is attributed to its secondary metabolites. M.citrifolia has very rich nutrients and consists of over 100 varieties of chemical compounds which have been isolated so far from the plant. In disorders such as skin ailments, respiratory infections, gastritis, menstrual, abortion, diabetes, and venereal diseases, it also shows beneficial effects.
Materials and Methods: The relation of noni juice or its extract (fruit, leaves or root) to anticancer and/or immunostimulant properties was investigated in this study. A Medline quest was performed along with cross-referencing using the main search terms 'Morinda citrifolia and cancer'.
Results: According to our search results for scientific studyM. citrifolia is used in literature for more than 40 forms of ailments. Crude extract is recorded from various plant and fruit juice components. There are records of amino acids, anthraquinones, fatty acids, flavonoids, iridoids, lignans, polysaccharides, sterols, carbohydrates, terpenoids, etc. in the crude extract of different sections of plant and fruit juice that are therapeutically beneficial for a wide range of pathological conditions.
Conclusion: Literature indicates that Nonii pharmacologically active and used in various cancer types (Colon, breast, esophageal, colorectal Cancers, cardiovascular disorders, diabetes, hypertension, arthritis). This plant's high potential classifies the compounds as the noteworthy medication of the future, and clinical trials are needed to demonstrate their effect on life-threatening diseases such as cancer. Further analysis warrants the isolation of the active components. These properties can be substantiated by the preclinical or/and clinical investigations.
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Shankar PR, Palaian S, Vannal V, Sreeramareddy CT. Non-Pharmacological Infection Prevention and Control Interventions in COVID-19: What Does the Current Evidence Say? Int J Prev Med 2021; 12:174. [PMID: 37663401 PMCID: PMC10472080 DOI: 10.4103/ijpvm.ijpvm_604_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 06/27/2021] [Indexed: 09/05/2023] Open
Abstract
Coronavirus disease-19 (COVID-19), a major global public health emergency has significantly impacted human health and livelihoods. The pandemic continues to spread and treatments and vaccines are at different stages of development. Mass vaccination has been rolled out worldwide. This review article provides a narrative summary of the evidence on various non-pharmacological interventions (NPIs) for COVID-19 containment. The authors reviewed the evidence published by the Norwegian Institute of Public Health map of COVID-19 evidence. Additional literature was identified from PubMed and Google Scholar, preprint sites, and news media. The search terms included "Social distancing measures" and "COVID 19", "Non-pharmacological interventions'' and "COVID 19", "COVID-19", "non-pharmacological interventions", "face mask", etc. The strength of the evidence for most studies on NPIs was 'weak to moderate' for restrictive NPIs. Ascertaining the impact of each NPI as a standalone intervention is difficult since NPIs are implemented simultaneously with other measures. Varying testing and reporting strategies across the countries and classification of deaths directly caused by COVID-19 create challenges in assessing the impact of restrictive NPIs on the case numbers and deaths. Evidence on hygiene measures such as face mask is more robust in design providing credible evidence on prevention of COVID-19 infection. Evidence from modeling studies, natural before-after studies, and anecdotal evidence from the strategies adopted by 'role model' countries suggests that continued use of NPIs is the only containment strategy until 'herd immunity' is achieved to reduce the severe disease and mortality.
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Affiliation(s)
- P. Ravi Shankar
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
| | - Subish Palaian
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-Allied Health Sciences, Research, Ajman University, Ajman, United Arab Emirates
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Abstract
Ziziphus jujuba Mill. (Z. jujube) is a conventional plant that has a long history of usage in nutrients and the therapeutic interventions of a wide range of ailments. It grows mainly in South and East Asia, and also in Australia and Europe. Mounting data supports the health advantages of Z. jujuba, including anticancer, anti-inflammation, anti-obesity, antioxidant, and hepato- and gastrointestinal protective characteristics. Chemotherapy, particularly with cis-diamminedichloroplatinium (CDDP, cisplatin) and its derivatives, is commonly used to treat cancer. Although it is an effective therapy for human tumors, drug resistance impedes successful treatment. A better knowledge of the processes and develop strategies to address chemoresistance can improve patient outcomes dramatically. Numerous researchers have recently focused their attention on the increasing occurrence of numerous types of malignancies worldwide. The anticancer efficacy of Z. jujuba was discussed in this review study.
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Rekha UV, Bhuminathan S, Shankar PR. Anti–Diabetic Activity of Murraya koenigii – A Comprehensive Review. JPRI 2021. [DOI: 10.9734/jpri/2021/v33i58b34226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Diabetes mellitus, one of the noncommunicable illnesses, is a severe problem worldwide as one of the leading causes of death. Because existing synthetic medications have various drawbacks, researchers are still looking for better anti-hyperglycemic treatments. Plants have been used in ancient medicine for thousands of years. India is the biggest producer of medicinal plants and is aptly regarded as the "World's Botanical Garden." Murraya koenigii Linn, also known as Meethi neem, is a Rutaceae plant. Curry trees are unique to India and likely found almost everywhere else on the subcontinent, except in the Himalayan highlands. For centuries, curry leaves were used as an antiemetic, diarrhea remedy, febrifuge, and blood purifier. Curry leaves are useful as an antioxidant, anti-diabetic, antibacterial, antihypertensive, cytotoxic, and in treating bronchial respiratory problems. Traditionally, the leaves were utilized as a spice in curries as well as other dishes. It includes coumarins and derivatives, alkaloids, flavonoids, phenolic compounds, and essential oil. Numerous studies have found that these phytochemicals have a significant effect on type 2 diabetes. This review focuses on this plant's anti-diabetic action and concludes that it has the potential to be evaluated as a candidate for developing a new diabetes mellitus medication.
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Shankar PR. Factors influencing the social obligation of doctors. Educ Health (Abingdon) 2021; 34:126-127. [PMID: 35488664 DOI: 10.4103/efh.efh_447_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- P Ravi Shankar
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
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Bhuvan KC, Shrestha R, Leggat PA, Ravi Shankar P, Shrestha S. Safety of air travel during the ongoing COVID-19 pandemic. Travel Med Infect Dis 2021; 43:102103. [PMID: 34111566 PMCID: PMC8180446 DOI: 10.1016/j.tmaid.2021.102103] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022]
Affiliation(s)
- K C Bhuvan
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
| | - Ranish Shrestha
- Infection Control Unit, Nepal Cancer Hospital and Research Center, Harisidhhi, 44700, Lalitpur, Nepal; Nepal Health Research and Innovation Foundation, Lalitpur, Nepal.
| | - Peter A Leggat
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - P Ravi Shankar
- IMU Center for Education, International Medical University, Kuala Lumpur, Malaysia.
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.
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Shankar PR, Wilson IG. The COVID-19 pandemic and undergraduate medical student teaching-learning and assessment. Can Med Educ J 2021; 12:e190-e191. [PMID: 33680254 PMCID: PMC7931464 DOI: 10.36834/cmej.70800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- P Ravi Shankar
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
- Correspondence to: P Ravi Shankar;
| | - Ian Geoffrey Wilson
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
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Gyawali S, Shankar PR, Saha A, Mohan L. Study of prescription of injectable drugs and intravenous fluids to inpatients in a teaching hospital in Western Nepal. Mcgill J Med 2020. [DOI: 10.26443/mjm.v12i1.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Unnecessary, excessive and poor injection practices in the South East Asia region (including Nepal) have been observed previously. The authors aim to study prescription of injectable drugs to inpatients in a teaching hospital in Western Nepal. Prescription of injectable drugs (IDs) and intravenous fluids (IVFs) to inpatients discharged from the wards of the Manipal Teaching Hospital during 1st January to 30th June 2006 was studied. The mean number of drugs, IDs and IVFs administered, median cost of drugs and of IDs/IVFs per prescription calculated. Comparison of ID/IVF use in the four major hospital departments (Medicine, Obstetrics and Gynecology, Pediatrics and Surgery) was done. The administration of IDs/IVFs and injectable antimicrobials were measured in Defined Daily Dose (DDD)/100 bed-days and of Intravenous fluid in Liters (L)/100 bed-days. Of the 1131 patients discharged, 938 (82.94%) patients received one or more IDs/IVFs. The mean number of drugs, IDs and IVFs prescribed were 8.75, 4.72 and 1.42. Median cost of drugs and IDs/IVFs per prescription were 8.26US$ and 5.12US$ respectively. IDs/IVFs accounted for 81.37% of total drug cost. The most commonly used ID, injectable antimicrobial and IVF were Diclofenac (19.3 DDD/100 bed-days), Metronidazole (7.68 DDD/100 bed-days) and Dextrose normal saline (8.56 L/100 bed-days), respectively. The total IVF consumption was 24.25 L/100 bed-days. Significant differences between departments were observed (p<0.05). In conclusion, the use of IDs/IVFs was higher compared to other studies. Interventions to improve IDs/IVFs prescribing practices may be required.
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Giri BR, Shankar PR. Letters to the MJM. Mcgill J Med 2020. [DOI: 10.26443/mjm.v10i2.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In response to "TRIPS agreement and public health" by Junaid Subhan.
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Alshakka M, Mohamed Ibrahim MI, Bahattab A, Badulla WFS, Shankar PR. An insight into the pharmaceutical sector in Yemen during conflict: challenges and recommendations. Med Confl Surviv 2020; 36:232-248. [PMID: 32718201 DOI: 10.1080/13623699.2020.1794287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In our world today, we need to understand, measure, and respond to inequality. The conflict and siege in Yemen have caused serious repercussions and consequences for the pharmaceutical sector and health of the people. Hospital, health centres and facilities, medicines warehouses and pharmaceutical factories have been destroyed. Further, the conflict has aggravated the health situation with shortages of medicines, an increase in chronic illnesses, and multiple epidemics and casualties. This article aims to highlight the challenges faced by the pharmaceutical sector in Yemen. It will address the overall state of health of the Yemeni people, as well as focus on the past, current status and future development of the pharmaceutical sector. Further, it will focus on possible remedial actions to solve some of these problems. These problems can be tackled if the responsible parties have the political will to do so. Acknowledging the different classes of problems is undeniably very important to provide clarity on the future of Yemen's supposedly promising pharmaceutical landscape.
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Affiliation(s)
- Mohammed Alshakka
- Section of Clinical Pharmacy, Faculty of Pharmacy, Aden University , Aden, Yemen
| | | | - Awsan Bahattab
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Aden University , Aden, Yemen
| | - Wafa F S Badulla
- Department of Analytical Chemistry, Faculty of Pharmacy, Aden University , Aden, Yemen
| | - P Ravi Shankar
- Department of Basic Sciences, Oceania University of Medicine , Apia, Samoa
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Shrestha S, Khatiwada AP, Gyawali S, Shankar PR, Palaian S. Overview, Challenges and Future Prospects of Drug Information Services in Nepal: A Reflective Commentary. J Multidiscip Healthc 2020; 13:287-295. [PMID: 32256077 PMCID: PMC7090186 DOI: 10.2147/jmdh.s238262] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/26/2020] [Indexed: 11/23/2022] Open
Abstract
Drug information center (DIC) or Medicine information services provides impartial, well-referenced, critically evaluated, updated information on various aspects of medications to healthcare professionals and consumers. Medicine information services also contribute to the minimization of medication errors by promoting medication education and supporting pharmaceutical services. The main objective of this reflective commentary is to highlight the recent scenario of medicine information services in Nepal, challenges for DIC, how DICs can be strengthened and future perspectives of DIC. The availability of medicine information in various online drug information sites and numerous applications (apps) have made it easier to assess the information in the country such as Nepal. However, the reliability and validity of such information should be considered before dissemination. DIC plays a crucial role in improving drug safety by aiding clinicians in safer use of medications and promoting adverse drug reaction (ADR) reporting in Nepal. Financial support for operating the DIC efficiently is scarce in Nepal resulting in operational problems. The performance of the medicine information services in the country should be evaluated periodically to ensure the good quality of the service. Steps should be taken by the government, private hospitals and regulatory bodies to sustain the already established DIC and to establish additional DICs in the future to provide quality health care service to the community.
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Affiliation(s)
- Sunil Shrestha
- Department of Pharmacy, Nepal Cancer Hospital and Research Center Pvt. Ltd, Lalitpur, Nepal.,Department of Pharmaceutical and Health Service Research, Nepal Health Research and Innovation Foundation, Lalitpur, Nepal
| | - Asmita Priyadarshini Khatiwada
- Department of Pharmaceutical and Health Service Research, Nepal Health Research and Innovation Foundation, Lalitpur, Nepal
| | - Sudesh Gyawali
- In-Charge, Drug Information Center, Manipal Teaching Hospital and Associate Professor, Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Kaski, Nepal
| | - P Ravi Shankar
- Department of Basic Medical Sciences, Oceania University of Medicine, Apia, Samoa
| | - Subish Palaian
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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Al-abd NM, Alshakka M, Alshotari S, Shankar PR, Ibrahim MIM. Knowledge, Attitudes and Practices Regarding Rubella Infection among Preparatory Year Students: A Preliminary Exploratory Study in Aden, Yemen. J Clin Diagn Res 2020. [DOI: 10.7860/jcdr/2020/44077.13681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Danekhu K, Shrestha S, Aryal S, Shankar PR. Health-care Professionals' Knowledge and Perception of Adverse Drug Reaction Reporting and Pharmacovigilance in a Tertiary Care Teaching Hospital of Nepal. Hosp Pharm 2019; 56:178-186. [PMID: 34024926 DOI: 10.1177/0018578719883796] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Underreporting of adverse drug reactions (ADRs) is common globally, and Nepal is not an exception to this. Health-care professionals (HCPs) play a vital role in reporting ADR during routine practice. Lack of knowledge and awareness about pharmacovigilance and reporting ADRs among HCPs may contribute to underreporting. Objective: The objective of this study was to evaluate the knowledge and perception of HCPs regarding ADR reporting and pharmacovigilance in a tertiary care teaching hospital in, Nepal. Methods: A descriptive cross-sectional study was conducted. A questionnaire was distributed to 215 HCPs (medical doctors, nurses, and pharmacists) between March and September 2018. Knowledge and perception regarding ADR reporting and pharmacovigilance were studied. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0 (IBM Corp, Armonk, New York). Results: The HCPs included 75 medical doctors, 126 nurses, and 14 pharmacists. Majority of the participants were female (67%), and the majority of participants were not aware of pharmacovigilance. Among the participants, pharmacists were found to have better knowledge regarding pharmacovigilance. However, other HCPs (doctors and nurses) strongly agreed about the necessity of having adequate knowledge about pharmacovigilance. Out of 215, 57.7% agreed that the important benefit of reporting ADR was to identify safe drugs and improve patient safety. The main reasons for not reporting were - ADR reporting was not widely promoted by relevant authorities (47%), followed by not knowing where and how to report ADR (34.9%). However, other HCPs (doctors and nurses) strongly agreed about the necessity of having adequate knowledge about pharmacovigilance. Conclusions: The knowledge of HCPs on ADR reporting and pharmacovigilance was poor. Despite a low knowledge of ADR reporting and pharmacovigilance among HCPs, there was a positive perception that ADR reporting is necessary and ADR monitoring system should be established in the hospital. This study also highlights a need for future intervention studies focusing on educating HCPs about ADR and pharmacovigilance.
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Affiliation(s)
- Krisha Danekhu
- Cogent Health Pvt Ltd, Lalitpur, Nepal.,Nepal Health Research and Innovation Foundation, Lalitpur, Nepal
| | - Sunil Shrestha
- Nepal Health Research and Innovation Foundation, Lalitpur, Nepal.,Nepal Cancer Hospital & Research Center, Lalitpur, Nepal
| | - Sushant Aryal
- Universal College of Medical Sciences, Tribhuvan University, Rupandehi, Nepal
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Shrestha S, Danekhu K, Thapa S, Khanal S, Shankar PR. The Unmet Need for Pharmacists as Important Members of the Emergency Department Team in Resource-Limited Settings: A Case of Nepal. J Pharm Technol 2019; 35:219-224. [PMID: 34752529 DOI: 10.1177/8755122519850118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The role of pharmacists in many developed countries has evolved from the traditional practice of dispensing medicines to contributing directly or indirectly to improve patient health outcomes. They are providing hospital services and patient care including services in the emergency department (ED). However, there is limited evidence for pharmacist involvement in the ED from resource-limited countries such as Nepal. Objective: The aim of this study is to discuss the role of pharmacists and highlight the unmet need of pharmacists in ED in Nepal. Methods: A narrative review of existing literature was conducted. Results: The status of ED services in Nepalese hospitals is not yet at a desirable level, and there is limited information about the role of pharmacists in EDs. Evidence obtained from developed nations on the role of pharmacists in EDs suggests that they help in improving patient outcomes by minimizing medication errors, adverse drug reactions, and enhance patient care. Conclusion: The study highlights the need for pharmacists in EDs in resource-limited settings. There is limited evidence of pharmacists' role in EDs from Nepal. Therefore, this study suggests a need for further studies on the possible contribution of pharmacists to ED services in Nepal.
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Affiliation(s)
- Sunil Shrestha
- Nepal Cancer Hospital and Research Center Pvt Ltd, Harisiddhi, Lalitpur, Nepal.,Nepal Health Research and Innovation Foundation, Lalitpur Nepal
| | - Krisha Danekhu
- Nepal Health Research and Innovation Foundation, Lalitpur Nepal.,Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Santosh Thapa
- Ashwins Medical College and Hospitals Pvt Ltd, Bhaisepati, Lalitpur, Nepal
| | - Saval Khanal
- Nepal Health Research and Innovation Foundation, Lalitpur Nepal
| | - P Ravi Shankar
- American International Medical University, Gros Islet, Saint Lucia
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Yousuf SA, Alshakka M, Badulla WFS, Ali HS, Shankar PR, Mohamed Ibrahim MI. Attitudes and practices of community pharmacists and barriers to their participation in public health activities in Yemen: mind the gap. BMC Health Serv Res 2019; 19:304. [PMID: 31088459 PMCID: PMC6515656 DOI: 10.1186/s12913-019-4133-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients in Yemen commonly visit community pharmacies to obtain consultation or treatment for common ailments. Community pharmacists have an opportunity to optimize medication use and improve patient outcomes. This study aimed to evaluate the attitudes and practices of community pharmacists regarding their participation in public health activities and barriers to their participation in these activities. METHODS This cross-sectional study was carried out among community pharmacists working in pharmacies located in urban areas of the Aden governorate of Yemen from March to June 2017 using a self-administered questionnaire. We selected pharmacies from a line list using proportional sampling according to the number of pharmacies in the urban areas of each district. The questionnaire contained four sections: demographic characteristics, attitudes, practices, and barriers encountered. Data were analyzed descriptively, and the Chi-square test was used for analyzing the association of variables (alpha = 0.05). RESULTS The questionnaire was distributed to 200 community pharmacists working in community pharmacies. Of the 200 respondents, 62% (n = 124) were male. Overall, the mean age (sd) was 30.0 years (8.6) with the number of years of work experience between 2 and 9.9 years (n = 158, 79%). On average, 62.3% of the pharmacists had a positive attitude toward participation in public health activities. Providing education to stop tobacco chewing, smoking, alcohol drinking and improve oral hygiene was an important activity of the community pharmacists. Blood pressure measurements (86%, n = 172) and glucose tests (45%, n = 90) were commonly conducted for clients. Lack of time (71%, n = 142) and lack of teamwork (70%, n = 140) were mentioned as common barriers to participation in public health activities. CONCLUSIONS Community pharmacists had a positive attitude toward public health activities. Health education and routine health tests were important practices of the community pharmacists. Barriers need to be overcome to enable more active participation by community pharmacists in public health activities by consulting with all stakeholders, assessing the situation, considering alternatives and taking action.
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Affiliation(s)
- Seena A Yousuf
- Social Medicine and Public Health Department, Faculty of Medicine and Health Sciences, Aden University, Aden, Yemen
| | - Mohammed Alshakka
- Section of Clinical Pharmacy, Faculty of Pharmacy, Aden University, Aden, Yemen.
| | - Wafa F S Badulla
- Department of Analytical Chemistry, Faculty of Pharmacy, Aden University, Aden, Yemen
| | - Heyam Saad Ali
- Department of Pharmaceutics, Dubai Pharmacy College, Dubai, United Arab Emirates
| | - P Ravi Shankar
- Department of Pharmacology, Health City University, Gros Islet, Saint Lucia
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Sapkota B, Rauniyar D, Shankar PR, Gupta GK, Thapa RK. Perception about Medicines among the General Public in the Semi-rural Areas of Nepal. Kathmandu Univ Med J (KUMJ) 2019; 17:93-100. [PMID: 32632054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background Patients' perceptions and beliefs about medicine are affected by their culture, tradition, socioeconomic status, peer influence, educational level, advertisements among other factors. Objective To explore the perception about medicines among the general public in different semi-rural areas of Nepal. Method Cross-sectional study was conducted at different locations within Kathmandu valley from July 2015 to December 2016; 385 individuals were approached using simple random sampling but only 260, aged 18 years and above, who were taking medicines for their health problems, completed the interviewer-administered survey. Their perceptions about medicines were studied using a structured questionnaire based on the WHO booklet "How to investigate the use of medicines by consumers" and analysed using SPSS version 22. Association between respondents' age, gender, education level and perception were statistically analysed using χ2 test and/or Fisher's exact test and multivariate analysis of variance. Result Sixty-one respondents (23.5%) were in age group 56-65 years. Patients' perceptions of medicine safety based on colour, shape, name of medicine, method of administration, compatibility, etc. was statistically different among respondents with regard to their level of education (p = 0.022). More individuals with lower education believed that expensive medicines were more effective (p < 0.001). Increased level of education made them more aware of negative consequences of reusing previous prescriptions (p=0.039). Conclusion Problems with knowledge about medicines were noted among lesser educated individuals. Based on findings, policy makers may develop educational strategies to increase awareness about medicines.
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Affiliation(s)
- B Sapkota
- Nobel College, Faculty of Health Sciences, Sinamangal, Kathmandu, Nepal
| | - D Rauniyar
- Patan Academy of Health Sciences, Patan Hospital, Lagankhel, Lalitpur, Nepal
| | | | | | - R K Thapa
- Patan Academy of Health Sciences, Patan Hospital, Lagankhel, Lalitpur, Nepal
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Giri BR, Chapagain RH, Sharma S, Shrestha S, Ghimire S, Shankar PR. Effect of the 2015 earthquake on pediatric inpatient pattern at a tertiary care hospital in Nepal. BMC Pediatr 2018; 18:28. [PMID: 29402263 PMCID: PMC5800012 DOI: 10.1186/s12887-018-1008-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 01/23/2018] [Indexed: 01/10/2023] Open
Abstract
Background Earthquakes impact child health in many ways. Diseases occurring immediately following an earthquake have been studied in field based hospitals but studies on the inpatient disease pattern among children without trauma in a permanent hospital setup is lacking. Methods We examined the diagnoses of all children without trauma, admitted to Kanti Children’s Hospital, Kathmandu for fifteen-week duration (from 4th week to end of the 18th week) following the 7.8 magnitude Nepal earthquake on 25th April 2015. The admitted children were grouped based on direct effect of earthquake on their family (house damaged or family member injured or dead) and on whether their place of residence was located in an earthquake affected district. Most common diagnoses were identified and their distribution between the aforementioned groups analyzed to examine differences, if any, in disease occurrence or presentation. The fifteen weeks study duration was divided into three parts of five weeks each, to study trends in illness presentation. Variables were compared among various groups using appropriate statistical tests (p < 0.05). Results A total of 1057 patients were admitted. The proportion of patients requiring admission for pneumonia, acute gastroenteritis and acute or poststreptococcal glomerulonephritis (AGN/PSGN) was significantly higher among children belonging to earthquake affected districts. Proportion of patients with any infective condition was also significantly higher in this group. Acute gastroenteritis and any infective condition were significantly higher among children from substantially affected families. The proportion of AGN/PSGN among admitted patients increased in successive time categories among patients from affected districts and from substantially affected families. Urinary Tract Infection, bronchiolitis, tuberculosis, pleural effusion, protein energy malnutrition/failure to thrive, nephrotic syndrome, meningitis/meningoencephalitis, epilepsy or seizure disorders, leukemia/malignancies, enteric fever, infective hepatitis and congenital heart disease were not significantly different among children from affected and not affected districts or between substantially affected and not affected families. Patients from substantially affected families were admitted to semi-intensive care ward or ICU in significantly higher proportions (12.6% vs 7.8%, p = 0.014). Conclusion Children seeking care for certain diseases were more likely to be from earthquake affected families and districts. Those from affected families required critical care more often. Electronic supplementary material The online version of this article (10.1186/s12887-018-1008-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bishnu Rath Giri
- Department of Pediatrics, National Academy of Medical Sciences, Kanti Children's Hospital, KMPC-3, Maharajgunj, Kathmandu, Postal Code: 44606, Nepal.
| | - Ram Hari Chapagain
- Department of Pediatrics, National Academy of Medical Sciences, Kanti Children's Hospital, KMPC-3, Maharajgunj, Kathmandu, Postal Code: 44606, Nepal
| | - Samana Sharma
- Department of Pediatrics, National Academy of Medical Sciences, Kanti Children's Hospital, KMPC-3, Maharajgunj, Kathmandu, Postal Code: 44606, Nepal
| | - Sandeep Shrestha
- Department of Pediatrics, National Academy of Medical Sciences, Kanti Children's Hospital, KMPC-3, Maharajgunj, Kathmandu, Postal Code: 44606, Nepal
| | - Sunita Ghimire
- Department of Pediatrics, National Academy of Medical Sciences, Kanti Children's Hospital, KMPC-3, Maharajgunj, Kathmandu, Postal Code: 44606, Nepal
| | - P Ravi Shankar
- American International Medical University, Gros Islet, Saint Lucia
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Alshakka M, Bahattab A, Shankar PR, Ansari M, Ali HS, Ibrahim MIM. Perception of Community Pharmacy Personnel towards Patient Counseling and Continuing Pharmacy Education Programs in Aden, Yemen. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/34106.11820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Jha N, Rathore DS, Shankar PR, Bhandary S, Alshakka M, Gyawali S. Knowledge, Attitude and Practice Regarding Pharmacovigilance and Consumer Pharmacovigilance among Consumers at Lalitpur District, Nepal. J Nepal Health Res Counc 2017; 15:31-37. [PMID: 28714489 DOI: 10.3126/jnhrc.v15i1.18011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Adverse drug reactions (ADRs) can be a big threat to the health of people in Nepal as a variety of medicines are consumed in the country. Involving consumers in pharmacovigilance can strengthen ADR reporting. The study aims to find out knowledge, attitude and practice regarding pharmacovigilance and consumer pharmacovigilance among consumers at Lalitpur district, Nepal Methods: It was carried out in outpatients visiting in KIST Medical College and Teaching Hospital, Lalitpur, Nepal. Participant's knowledge, attitude and practice were measured by noting their agreement with a set of 21 statements along with multiple choice and open ended questions. RESULTS A total of 157 outpatients were surveyed. The knowledge scores for males (12) was better compared to the females (11), but the scores for attitude and practice were same for both groups. The maximum score for knowledge was 29, attitude was 6 and practice was 10. The overall KAP scores was 45. The total scores for knowledge, attitude and practice for males (24) were better compared to female (22) respondents. Seventy-one patients (68%) who participated in this study favoured establishing a consumer centre for obtaining information about ADRs. CONCLUSIONS Knowledge scores among consumers regarding pharmacovigilance is low and require advocacy and improvement.
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Affiliation(s)
- N Jha
- Department of Clinical Pharmacology, KIST Medical College, Lalitpur, Nepal
| | - D S Rathore
- Department of Pharmacy, NIMS University, Rajasthan, India
| | - P R Shankar
- Department of Pharmacology, American International Medical University, St. Lucia, caribbean
| | - S Bhandary
- Department of Community Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - M Alshakka
- Department of Pharmaceutics and Clinical Pharmacy, Aden University, Yemen
| | - S Gyawali
- Department of Clinical Pharmacology, Manipal College of Medical Sciences, Kaski, Nepal
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Shankar PR. Commentary on Chemotherapy. Acad Med 2017; 92:77. [PMID: 28027102 DOI: 10.1097/01.acm.0000511910.04349.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- P Ravi Shankar
- P.R. Shankar is assistant dean for medical education and professor of medical education, Xavier University School of Medicine, Oranjestad, Aruba; ; Twitter: @drprshankar
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Shankar PR, Herz BL, Dubey AK, Hassali MA. Assessment of knowledge and perceptions toward generic medicines among basic science undergraduate medical students at Aruba. Indian J Pharmacol 2016; 48:S29-S32. [PMID: 28031604 PMCID: PMC5178050 DOI: 10.4103/0253-7613.193309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: Use of generic medicines is important to reduce rising health-care costs. Proper knowledge and perception of medical students and doctors toward generic medicines are important. Xavier University School of Medicine in Aruba admits students from the United States, Canada, and other countries to the undergraduate medical (MD) program. The present study was conducted to study the knowledge and perception about generic medicines among basic science MD students. Materials and Methods: The cross-sectional study was conducted among first to fifth semester students during February 2015. A previously developed instrument was used. Basic demographic information was collected. Respondent’s agreement with a set of statements was noted using a Likert-type scale. The calculated total score was compared among subgroups of respondents. One sample Kolmogorov–Smirnov test was used to study the normality of distribution, Independent samples t-test to compare the total score for dichotomous variables, and analysis of variance for others were used for statistical analysis. Results: Fifty-six of the 85 students (65.8%) participated. Around 55% of respondents were between 20 and 25 years of age and of American nationality. Only three respondents (5.3%) provided the correct value of the regulatory bioequivalence limits. The mean total score was 43.41 (maximum 60). There was no significant difference in scores among subgroups. Conclusions: There was a significant knowledge gap with regard to the regulatory bioequivalence limits for generic medicines. Respondents’ level of knowledge about other aspects of generic medicines was good but could be improved. Studies among clinical students in the institution and in other Caribbean medical schools are required. Deficiencies were noted and we have strengthened learning about generic medicines during the basic science years.
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Affiliation(s)
- P Ravi Shankar
- Department of Pharmacology and Clinical Medicine, Xavier University School of Medicine, Oranjestad, Aruba
| | - Burton L Herz
- Department of Pharmacology and Clinical Medicine, Xavier University School of Medicine, Oranjestad, Aruba
| | - Arun K Dubey
- Department of Pharmacology and Clinical Medicine, Xavier University School of Medicine, Oranjestad, Aruba
| | - Mohamed A Hassali
- Discipline of Social and Administrative Pharmacy, Universiti Sains Malaysia, Penang, Malaysia
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Shankar PR, Dwivedi N, Bhandary S, Majhi S, Varela L, Nandy A. Basic Science Medical Student Attitudes toward the Patient-Doctor Relationship. MedEdPublish 2016. [DOI: 10.15694/mep.2016.000165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This article was migrated. The article was marked as recommended. Introduction: Patients seem increasingly to be in favor of taking a more active role in the patient-doctor relationship. Increasing education and the rising prevalence of chronic and lifestyle diseases require patients to take more responsibility for their health. The present study was conducted among basic science students at a private medical school in Aruba, Dutch Caribbean using the well validated patient-practitioner orientation scale (PPOS) to obtain information on student attitudes toward the patient-doctor-relationship and study whether the attitudes were associated with demographic characteristics.Methods: The study was conducted during November 2016. PPOS measures student attitudes towards the sharing and caring dimensions of the patient-doctor relationship by noting the respondents' degree of agreement with various statements using a Likert-type scale.The gender, age, nationality and semester of study of the respondents were noted. Three binary dependent variables were created using mean caring, mean sharing and mean total scores where mean score of 4 and greater was coded as 1 and otherwise was coded as 0. Subsequently, univariate and multivariate logistic regression models were fitted to analyze the relationship of the dependent variables with gender, age, nationality and semester of study of the respondents.Results: One hundred and seven of the total of 116 students (92.2%) participated in the study.The mean ± SD sharing score was 3.996 ± 0.623 while the mean caring score was 4.253 ± 0.0602. The mean ± SD total score was 4.126 ± 0.501.The mean sharing and mean total scores were significantly higher among female respondents. Female respondents were found to be more likely to be caring, sharing and having a more patient-centered attitude when communicating with patients than males on carrying out the logistic regression analysis.Conclusions: The scores were comparable to those reported previously in the literature. Compared to some other studies no significant differences in scores were noted according to demographic characteristics of respondents other than gender. Studies among students during the clinical years of study are required. Similar studies could be carried out in other offshore Caribbean medical schools.
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Shankar PR, Dubey AK, Dwivedi NR, Nandy A, Barton B. Knowledge, perception and practice of self-medication among premedical and basic science undergraduate medical students. Asian J Med Sci 2016. [DOI: 10.3126/ajms.v7i6.15246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims and Objective: Responsible self-medication is recognized as an important component of self-care. Medical students are in a unique position as they cannot yet legally prescribe medicines but their knowledge about and exposure to medicines increase as they progress through their course. Xavier University School of Medicine in Aruba admits students mainly from the United States, Canada and other countries to the undergraduate medical course. The present study was carried out to study the knowledge, perceptions and practice of self-medication among premedical and undergraduate medical students.Materials and Methods: The study was conducted during June and July 2016 using a questionnaire which had been used previously. Knowledge and perceptions were studied by noting the respondents’ degree of agreement with asset of 40 statements. The use of selected classes of medicines for self-medication during the preceding one-year period was studied. The knowledge, perception and total scores were calculated and compared among different subgroups of respondents. Age, gender, nationality and semester of study of the respondents were noted.Results: Eighty-five of the 125 students enrolled (69.1%) participated. The mean knowledge, perception and total scores were 73.45, 62.75 and 136.2 (maximum possible scores were 105, 95 and 200 respectively). There was no significant difference in scores among subgroups of respondents. Analgesics, skin ointments, antipyretics and anti-allergics were commonly used for self-medication. Over half the respondents had used some form of self-medication during the preceding year. Conclusion: The present study provides preliminary information regarding self-medication practices among both premedical and basic science medical students. Further studies on factors influencing and information sources used during self-medication can be conducted. Asian Journal of Medical Sciences Vol.7(5) 2016 63-68
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Abstract
Objective: Standardized patients (SPs) are widely used in medical and other health professions education. At xxxx SPs have been used for teaching-learning and assessment of basic science medical students since January 2013. The opinion of SPs about their involvement in teaching-learning and assessment of students has been recently studied. The present study had the objective of studying student perception about various aspects of the program.Materials and Methods: The study was conducted towards end of March and beginning of April 2016. Student perception regarding the program was studied by noting their degree of agreement with a set of 25 statements. Free text comments were also obtained. Gender, nationality and semester of study of the respondents was noted. The total score was compared among different subgroups of respondents.Results: Ninety-eight of the 107 students (91.6%) participated. The mean ± SD total score was 92.33 ± 13.68 (maximum possible score being 125). The scores were significantly higher among first semester students compared to other semesters. Students agreed that interacting with SPs will prepare them for interacting with patients, for their licensing exams and improve their clinical skills. Students learn how to interact with persons from a different cultural background. Suggestions for further improvement were also obtained. Conclusions: The response rate was high and students’ perception of the SP program was positive. Our experiences would be of special interest to educators in other medical schools with small and/or new SP programs. Similar feedback could be obtained from other xxx schools with SP programs.Asian Journal of Medical Sciences Vol.7(5) 2016 102-107
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Mishra SK, Jha N, Shankar PR, Dahal PK, Khatiwada B, Sapkota YD. An Assessment of Diabetic Retinopathy and Diabetes Management System in Nepal. J Nepal Health Res Counc 2016; 14:104-110. [PMID: 27885292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Visual damage due to diabetic retinopathy is a major concern which can be reduced through appropriate coordination and cooperation between the diabetes management services and diabetic retinopathy services. The study assessed the existence, availability and accessibility of health care services for diabetes mellitus and diabetic retinopathy in Nepal. METHODS The study was carried out from 1 April to 24 June 2015. The tool for assessment of diabetic retinopathy and diabetes management systems developed by the World Health Organization was used for the assessment of major stakeholders like endocrinologists, ophthalmologists, ophthalmic assistants, nurses involved in diabetes care, patients and human resources from Ministry of Health and Population and international non-governmental organizations dealing with eye care services in Nepal. RESULTS Thirty-seven key stakeholders were selected for the study. Six out of fifteen ophthalmologists were unaware about the prioritization of diabetes as national health concern. The main function of diabetes association included patient education and awareness 18(48.6%), clinician education and awareness 16(43.2%). Thirteen professionals (35.1%) said that the patients were not found to be aware about diabetic patients' organizations. The information to community is provided occasionally and only through national-level media. All forms of diabetes care were funded out-of-pocket by the patients themselves. CONCLUSIONS Coordination should be strengthened for an effective and holistic management of diabetes mellitus making diabetes care and diabetic retinopathy services more accessible. Diabetes mellitus and its complications are becoming a public health threat in Nepal.
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Affiliation(s)
- S K Mishra
- Nepal Netra Jyoti Sangh, Tripureshwor, Kathmandu, Nepal
| | - N Jha
- Department of Clinical Pharmacology, KIST Medical College, Lalitpur, Nepal
| | - P R Shankar
- Department of Pharmacology, Xavier University of School of Medicine, Aruba, Kingdom of Netherlands
| | - P K Dahal
- Department of Community Medicine, KIST Medical College, Lalitpur, Nepal
| | - B Khatiwada
- Nepal Technical Assistance Group, Maitighar, Kathmandu, Nepal
| | - Y D Sapkota
- International Agency for of Prevention of Blindness, India
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Gyawali S, Rathore DS, Shankar PR, Kc VK, Jha N, Sharma D. Knowledge and Practice on Injection Safety among Primary Health Care Workers in Kaski District, Western Nepal. Malays J Med Sci 2016; 23:44-55. [PMID: 27540325 PMCID: PMC4975588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 11/07/2015] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Unsafe injection practice can transmit various blood borne infections. The aim of this study was to assess the knowledge and practice of injection safety among injection providers, to obtain information about disposal of injectable devices, and to compare the knowledge and practices of urban and rural injection providers. METHODS The study was conducted with injection providers working at primary health care facilities within Kaski district, Nepal. Ninety-six health care workers from 69 primary health care facilities were studied and 132 injection events observed. A semi-structured checklist was used for observing injection practice and a questionnaire for the survey. Respondents were interviewed to complete the questionnaire and obtain possible explanations for certain observed behaviors. RESULTS All injection providers knew of at least one pathogen transmitted through use/re-use of unsterile syringes. Proportion of injection providers naming hepatitis/jaundice as one of the diseases transmitted by unsafe injection practice was significantly higher in urban (75.6%) than in rural (39.2%) area. However, compared to urban respondents (13.3%), a significantly higher proportion of rural respondents (37.3%) named Hepatitis B specifically as one of the diseases transmitted. Median (inter-quartile range) number of therapeutic injection and injectable vaccine administered per day by the injection providers were 2 (1) and 1 (1), respectively. Two handed recapping by injection providers was significantly higher in urban area (33.3%) than in rural areas (21.6%). Most providers were not aware of the post exposure prophylaxis guideline. CONCLUSION The knowledge of the injection providers about safe injection practice was acceptable. The use of safe injection practice by providers in urban and rural health care facilities was almost similar. The deficiencies noted in the practice must be addressed.
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Affiliation(s)
- Sudesh Gyawali
- Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Kaski, Pin code: 33700, Nepal
| | - Devendra Singh Rathore
- NIMS Institute of Pharmacy, NIMS University, Shobha Nagar, Jaipur-Delhi Highway, Jaipur, Pin code: 303121, India
| | - P Ravi Shankar
- Department of Pharmacology, Xavier University School of Medicine, Oranjestad, Aruba, Kingdom of the Netherlands
| | - Vikash Kumar Kc
- Department of Statistics, Prithvi Narayan Multiple Campus, Pokhara, Kaski, Pin code 33700, Nepal
| | - Nisha Jha
- Department of Clinical Pharmacology and Therapeutics, KIST Medical College, Imadol, Lalitpur, Pin code: 44705, Nepal
| | - Damodar Sharma
- Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Kaski, Pin code: 33700, Nepal
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Gyawali S, Shankar PR, Poudel PP, Saha A. Knowledge, Attitude and Practice of Self-Medication Among Basic Science Undergraduate Medical Students in a Medical School in Western Nepal. J Clin Diagn Res 2015; 9:FC17-22. [PMID: 26816912 DOI: 10.7860/jcdr/2015/16553.6988] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 11/04/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Studies have shown self-medication to be common among medical students. These studies are however, few in Nepal. The present study assessed knowledge, attitude, and practice of self-medication among second and fourth semesters' undergraduate medical students and studied differences in knowledge and attitude (if any) among different subgroups of the respondents. MATERIALS AND METHODS A cross-sectional survey was conducted using a questionnaire among basic science medical students of Manipal College of Medical Sciences, Nepal. Semester of study, gender, age, nationality, and the profession of their parents were noted. Students' knowledge and attitude about self-medication was studied by noting their degree of agreement with a set of 40 statements using a Likert-type scale. The average scores and frequency of occurrence of particular behaviors among different categories of respondents were compared using appropriate statistical tests. RESULTS Two hundred and seventy-six of the 295 (93.6%) students participated. The mean (SD) knowledge, attitude, and total scores were 74.54 (6.92), 67.18 (5.68), and 141.73 (10.76) with maximum possible scores 100, 100 and 200, respectively. There was no significant difference in scores according to respondents' gender, age, and the profession of their parents. However, the mean knowledge, attitude and total scores were significantly different among students of different nationalities. Mean scores of fourth semester students were significantly higher compared to second semester students. There were differences in knowledge and total scores among students of different nationalities. Eighty two percent of respondents had self-medicated during the one year period preceding the study; 149 respondents (54%) shared that previous experience with the medicine was one of the information sources for self-medication. Prevalence of self-medication among respondents according to semester of study, gender, age, and profession of the parents was not significantly different. The use of self-medication was more common among Sri Lankan respondents compared to Nepalese. Painkillers (73.2%), antipyretics (68.8%), and antimicrobials (56.2%) were most commonly used for self-medication. CONCLUSION Students' knowledge and attitude about self-medication is good. The prevalence of self-medication among medical students was high.
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Affiliation(s)
- Sudesh Gyawali
- Assistant Professor, Department of Pharmacology, Manipal College of Medical Sciences (MCOMS) , Deep height, Pokhara, Nepal
| | - P Ravi Shankar
- Professor, Department of Pharmacology, Xavier University School of Medicine , Oranjestad, Aruba, Kingdom of the Netherlands
| | - Phanindra Prasad Poudel
- Assistant Professor, Department of Anatomy, Manipal College of Medical Sciences (MCOMS) , Deep height, Pokhara, Nepal
| | - Archana Saha
- Professor and Head, Department of Pharmacology, Manipal College of Medical Sciences (MCOMS) , Deep height, Pokhara, Nepal
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Affiliation(s)
- P Ravi Shankar
- Department of Pharmacology, Xavier University, School of Medicine, Aruba, Netherlands. E-mail.
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Abstract
Purpose: Interprofessional collaboration (IPC) and interprofessional education (IPE) are increasingly emphasized in the education of health professions. Xavier University School of Medicine, a Caribbean medical school admits students from the United States, Canada, and other countries to the undergraduate medical course. The present study was carried out to obtain information about the attitude toward IPC among basic science medical students and note differences, if any, among different subgroups. Methods: The study was conducted among first to fifth semester students during July 2015 using the previously validated Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC). Gender, age, semester, and nationality were noted. Participants’ agreement with a set of 20 statements was studied. Mean total scores, working relationship, and accountability scores were calculated and compared among different subgroups of respondents (p<0.05). Results: Sixty-seven of the 71 students (94.4%) participated. Cronbach’s alpha value of the questionnaire was 0.827, indicating good internal consistency. The mean total score was 104.48 (maximum score 140) while the working relationship and accountability scores were 63.51 (maximum score 84) and 40.97 (maximum score 56), respectively. Total scores were significantly higher among third-semester students and students of Canadian nationality. Working relationship and accountability scores were higher among first and third-semester students. Conclusion: The total working relationship and accountability scores were lower compared to those obtained in a previous study. Opportunities for IPE and IPC during the basic science years should be strengthened. Longitudinal studies in the institution may be helpful. Similar studies in other Caribbean medical schools are required.
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Affiliation(s)
- P Ravi Shankar
- Pharmacology, Medical Education, Xavier University School of Medicine
| | | | - Atanu Nandy
- Microbiology, Xavier University School of Medicine
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Baysari MT, Welch S, Richardson K, Sharratt G, Clough J, Heywood M, Melocco T, Harvey PA, Jennings R, Carter L, Elliott RA, Shankar PR, Hoenemann D, Wan V, Luetsch K, Burrows J, Lui V. Letters to the Editor. Journal of Pharmacy Practice and Research 2015. [DOI: 10.1002/j.2055-2335.2012.tb00178.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Melissa T Baysari
- Australian Institute of Health Innovation, Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital; University of New South Wales; Darlinghurst NSW 2010
| | - Susan Welch
- St Vincent's Hospital; The University of Sydney
| | | | | | | | | | | | | | | | | | - Rohan A Elliott
- Centre for Medicine Use and Safety; Monash University, Austin Health; Heidelberg Vic. 3084
| | - P Ravi Shankar
- Department of Clinical Pharmacology and Therapeutics; KIST Medical College; Lalitpur Nepal
| | | | - Verna Wan
- Department of Health; Melbourne Vic. 3000
| | | | - Judy Burrows
- School of Pharmacy, Pharmacy Australia Centre of Excellence; The University of Queensland; Woolloongabba Qld 4102
| | - Viki Lui
- Royal Park Campus; Royal Melbourne Hospital; Parkville Vic. 3052
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Affiliation(s)
- Rabindranath Das
- Department of Medicine; Manipal Teaching Hospital; Pokhara Nepal
- Department of Pharmacology; Manipal Teaching Hospital; Pokhara Nepal
| | - P Ravi Shankar
- Department of Pharmacology; Manipal Teaching Hospital; Pokhara Nepal
| | - Krishna Dhungana
- Department of Medicine; Manipal Teaching Hospital; Pokhara Nepal
- Department of Pharmacology; Manipal Teaching Hospital; Pokhara Nepal
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Shankar PR. Initiating small group learning in a Caribbean medical school. J Educ Eval Health Prof 2015; 12:10. [PMID: 25855388 PMCID: PMC4397842 DOI: 10.3352/jeehp.2015.12.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 04/09/2015] [Indexed: 06/04/2023]
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Shankar PR. Challenges in shifting to an integrated curriculum in a Caribbean medical school. J Educ Eval Health Prof 2015; 12:9. [PMID: 25855387 PMCID: PMC4397856 DOI: 10.3352/jeehp.2015.12.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 04/08/2015] [Indexed: 06/04/2023]
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Dwivedi NR, Dubey AK, Shankar PR. Intraoperative and Immediate Postoperative Outcomes of Cataract Surgery using Phacoemulsification in Eyes with and without Pseudoexfoliation Syndrome. J Clin Diagn Res 2015; 8:VC01-VC05. [PMID: 25654013 DOI: 10.7860/jcdr/2014/10004.5277] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 09/17/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND To compare the intraoperative and immediate postoperative behavior and complications in eyes with pseudoexfoliation (PEX) syndrome with eyes having senile cataract without PEX during cataract surgery using phacoemulsification (PKE). MATERIALS AND METHODS In this prospective study, 68 eyes of 68 patients were divided into two groups: Group 1 (test) comprised 34 eyes with immature senile cataract with PEX and Group 2 (control) included 34 eyes with immature senile cataract without PEX and any coexisting ocular pathology. Phacoemulsification (modern cataract surgery) was performed on both groups through stop and chop technique and comparative analysis of the incidence of intraoperative and immediate postoperative complications was made. RESULTS There was no significant difference in rates of intraoperative complications between PEX (2.9%) and Control (0%) group. The mean pupil diameter was significantly smaller in Group 1 (p<0.001). No eye in either group had phacodonesis. 58.8% of eyes in Group 1 and 29.4% in Group 2 had a harder cataract (nuclear sclerosis) ≥ grade 3 (p=0.017). PKE was performed in all eyes with cataract in both groups. Intraoperative complication (zonular dialysis (dehiscence) was encountered in only 2.9% (1 case) of eyes with PEX. PC (posterior capsule) tear (rent) with vitreous loss was seen in 2.9% eyes of Group 1 and none in Group 2. Postoperatively, IOP (intraocular pressure) and aqueous flare response were comparable between the groups. Significantly higher inflammatory cell response was observed in Group 1 (p=0.014). BCVA (best corrected visual acuity) using Snellen chart with pinhole on postoperative day1 was significantly better in the control group compared to the group with PEX (p=0.027). CONCLUSION Phacoemulsification can be safely performed by experienced hands in cataractous eyes with PEX. The incidence of intraoperative and immediate post-operative complications in eyes with PEX was not significantly different compared to eyes without PEX in our study. Further studies among a larger population are required.
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Affiliation(s)
- Neelam R Dwivedi
- Associate Professor, Department of Clinical Medicine, Associated with Xavier University School of Medicine , Aruba, Kingdom of the Netherlands
| | - Arun K Dubey
- Professor, Department of Pharmacology, Associated with Xavier University School of Medicine , Aruba, Kingdom of the Netherlands
| | - P Ravi Shankar
- Professor, Department of Pharmacology, Associated with Xavier University School of Medicine , Aruba, Kingdom of the Netherlands
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Shankar PR. An online nutrition in medicine module: an important resource for medical students and physicians. Educ Health (Abingdon) 2015; 28:109-110. [PMID: 26261128 DOI: 10.4103/1357-6283.161954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- P Ravi Shankar
- Department of Pharmacology, School of Medicine, Xavier University, Oranjestad, Aruba, Kingdom of the Netherlands
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Abstract
BACKGROUND Problem-based learning (PBL) sessions consist of a brainstorming phase, search phase, individual study, and reporting phase. At the Xavier University School of Medicine, Aruba, PBL is a new learning modality first introduced in May 2013. AIMS PBL processes have not been studied previously at the Xavier University School of Medicine, hence the present study was carried out to obtain information about the PBL processes and note differences, if any, among different groups of students. METHOD The study was conducted among first- to fourth-semester undergraduate medical students during July 2014 using a previously validated PBL processes instrument developed by van den Hurk et al. Information about gender, semester, weekly hours of study, and learning resources used was obtained. Respondents' agreement with a set of 23 statements was noted using a Likert-type scale, which was scored as 1=totally disagree with the statement, 2=disagree, 3=neutral, 4=agree, and 5=totally agree with the statement. Mean scores were compared among different groups of respondents. RESULTS Fifty-one of the 58 students (87.9 per cent) participated. The weekly average study time was 29.9 hours. Lecture handouts and textbooks were commonly used information sources. The mean scores (scale 1 to 5) for learning-issue-driven searching, and extensiveness of searching were 3.49 and 3.45, respectively. The score for explanation-oriented preparation was 3.94, while those for breadth and depth of discussion were 3.75 and 3.62, respectively. Most scores were higher among second-semester students, but the difference was not significant. CONCLUSION The self-reported scores were comparable to those reported in previous studies done using the same PBL processes instrument in other medical schools. At Xavier University School of Medicine interactive lectures are the major teaching method and topics covered during PBL are also likely to be covered during lectures, which could influence the scores. The findings of our study providing information about how students function during PBL brainstorming and presentation sessions and how they use different learning resources would be of interest to other medical schools worldwide following a hybrid curriculum. Further studies are required.
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Jha N, Rathore DS, Shankar PR, Gyawali S, Alshakka M, Bhandary S. An educational intervention's effect on healthcare professionals' attitudes towards pharmacovigilance. Australas Med J 2014; 7:478-89. [PMID: 25646124 DOI: 10.4066/amj.2014.2235] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pharmacovigilance concerns the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. Consumer pharmacovigilance is the involvement of consumers in adverse drug reaction (ADR) reporting. Assessing healthcare professionals' (HCPs) knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance is integral to strengthening adverse drug reaction reporting systems. AIMS To study knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance among HCPs from KIST Medical College, Lalitpur, Nepal, and to plan an appropriate educational intervention to address deficiencies noted. METHOD The study was conducted from February 2013 to December 2013 at KIST Medical College using a self-administered, pretested, structured questionnaire. The maximum possible scores for knowledge, attitude, and total were 100, 95, and 195, respectively. Baseline knowledge and attitude were studied. Two months after the questionnaire, an intervention that used a combination of methods about pharmacovigilance and consumer pharmacovigilance was undertaken. Knowledge and attitudes were studied immediately after the intervention. Scores before and after the intervention were compared using Wilcoxon signed-rank test. RESULTS A total of 105 HCPs participated. The median (interquartile range) knowledge, attitude, and total scores before the intervention were 56 (7), 72 (9), and 127 (16), respectively. After the intervention the scores increased significantly to 72 (8), 75 (11.5), and 146 (16.5) (p<0.001), respectively. CONCLUSION The intervention was effective in improving HCPs' knowledge of and attitude towards pharmacovigilance and consumer pharmacovigilance. More studies on this topic among HCPs at other institutions and in the community are required.
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Affiliation(s)
- Nisha Jha
- KIST Medical College, Lalitpur, Nepal
| | | | - P Ravi Shankar
- Xavier University, School of Medicine, Oranjestad, Aruba
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Shankar PR. Medical humanities: developing into a mainstream discipline. J Educ Eval Health Prof 2014; 11:32. [PMID: 25417866 PMCID: PMC4309934 DOI: 10.3352/jeehp.2014.11.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 11/24/2014] [Indexed: 06/04/2023]
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Shankar PR. Designing and conducting a two day orientation program for first semester undergraduate medical students. J Educ Eval Health Prof 2014; 11:31. [PMID: 25417865 PMCID: PMC4309944 DOI: 10.3352/jeehp.2014.11.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 11/24/2014] [Indexed: 06/04/2023]
Affiliation(s)
- P. Ravi Shankar
- Departments of Pharmacology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
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Shankar PR, Balasubramanium R, Dwivedi NR, Nuguri V. Student feedback about the integrated curriculum in a Caribbean medical school. J Educ Eval Health Prof 2014; 11:23. [PMID: 25270090 PMCID: PMC4309931 DOI: 10.3352/jeehp.2014.11.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 09/29/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE Xavier University School of Medicine adopted an integrated, organ system-based curriculum in January 2013. The present study was aimed at determining students' perceptions of the integrated curriculum and related assessment methods. METHODS The study was conducted on first- to fourth-semester undergraduate medical students during March 2014. The students were informed of the study and subsequently invited to participate. Focus group discussions were conducted. The curriculum's level of integration, different courses offered, teaching-learning methods employed, and the advantages and concerns relating to the curriculum were noted. The respondents also provided feedback about the assessment methods used. Deductive content analysis was used to analyze the data. RESULTS Twenty-two of the 68 students (32.2%) participated in the study. The respondents expressed generally positive opinions. They felt that the curriculum prepared them well for licensing examinations and future practice. Problem-based learning sessions encouraged active learning and group work among students, thus, improving their understanding of the course material. The respondents felt that certain subjects were allocated a larger proportion of time during the sessions, as well as more questions during the integrated assessment. They also expressed an appreciation for medical humanities, and felt that sessions on the appraisal of literature needed modification. Their opinions about assessment of behavior, attitudes, and professionalism varied. CONCLUSION Student opinion was positive, overall. Our findings would be of interest to other medical schools that have recently adopted an integrated curriculum or are in the process of doing so.
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Affiliation(s)
- P. Ravi Shankar
- Departments of Pharmacology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Ramanan Balasubramanium
- Departments of Pathology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Neelam R. Dwivedi
- Departments of Clinical Medicine, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Vivek Nuguri
- Departments of Pathology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
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Abstract
In Nepal, reporting of adverse drug reactions (ADRs) occurs on a voluntary basis by doctors, pharmacists, nurses, health assistants, and other healthcare professionals. The country's pharmacovigilance program is still in its infancy; it has limited coverage and underreporting is common. This major limitation could be reduced with consumer involvement. This report examines the necessity and benefits of consumer involvement in Nepal's existing pharmacovigilance program, reflecting on existing examples of consumer pharmacovigilance in different countries to highlight the necessity for such a framework in Nepal.
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Affiliation(s)
| | | | | | | | - Gajendra Bhuju
- Director General, Department of Drug Administration, Nepal
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Shankar PR, Bharti R, Ramireddy R, Balasubramanium R, Nuguri V. Students' perception of the learning environment at Xavier University School of Medicine, Aruba: a follow-up study. J Educ Eval Health Prof 2014; 11:9. [PMID: 24798426 PMCID: PMC4083226 DOI: 10.3352/jeehp.2014.11.9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 05/06/2014] [Indexed: 05/24/2023]
Abstract
Xavier University School of Medicine admits students mainly from the United States and Canada to the undergraduate medical program. A previous study conducted in June 2013 used the Dundee Ready Educational Environment Measure to measure the educational environment and impact of different teaching and learning methods in the program. The present study aims to obtain information about students' perceptions of changes in the educational environment, which underwent modifications in teaching and learning, in January 2014. Information was collected about the participants' semester of study, gender, nationality, and age. Students' perceptions of the educational environment were documented by noting their degree of agreement with a set of 50 statements grouped into five categories. Average scores were compared among different groups. The mean total and category scores were compared to those of the 2013 study. Sixty of the sixty-nine students (86.9%) who enrolled in the undergraduate medical program participated in the survey. The majority were male, aged 20-25 years, and of American nationality. The mean±SD total score was 151.32±18.3. The mean scores for students' perception in the survey categories were perception of teaching/learning (38.45), perception of teachers (33.90), academic self-perceptions (22.95), perception of atmosphere (36.32), and social self-perception (19.70). There were no significant differences in these scores among the different groups. All scores except those for academic self-perception were significantly higher in the present study compared to the previous one (P<0.05). The above results will be of particular interest to schools that plan to transition to an integrated curriculum.
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Affiliation(s)
- P. Ravi Shankar
- Departments of Pharmacology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Rishi Bharti
- Departments of Epidemiology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Ravi Ramireddy
- Departments of Biochemistry, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Ramanan Balasubramanium
- Departments of Pathology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Vivek Nuguri
- Departments of Pathology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
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Abstract
Medical Humanities is a relatively new concept even in developed countries, and is at the infancy stage in low income countries like Nepal. Medical humanities modules in Nepal are being conducted in a few medical schools. Humanities have an essential role in medical education, the gap between the humanities and medicine has to be bridged and there should be continuous and vigorous debate about the theory and practice of medical humanities
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Shankar PR, Nandy A, Balasubramanium R, Chakravarty S. Small group effectiveness in a Caribbean medical school's problem-based learning sessions. J Educ Eval Health Prof 2014; 11:5. [PMID: 24699510 PMCID: PMC3992470 DOI: 10.3352/jeehp.2014.11.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 03/18/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE The Tutorial Group Effectiveness Instrument was developed to provide objective information on the effectiveness of small groups. Student perception of small group effectiveness during the problem base learning (PBL) process has not been previously studied in Xavier University School of Medicine (Aruba, Kingdom of the Netherlands); hence, the present study was carried out. METHODS The study was conducted among second and third semester undergraduate medical students during the last week of September 2013, at Xavier University School of Medicine of the Netherlands. Students were informed about the objectives of the study and invited to participate after obtaining written, informed consent. Demographic information like gender, age, nationality, and whether the respondent had been exposed to PBL before joining the institution was noted. Student perception about small group effectiveness was studied by noting their degree of agreement with a set of 19 statements using a Likert-type scale. RESULTS Thirty-four of the 37 (91.9%) second and third semester medical students participated in the study. The mean cognitive score was 3.76 while the mean motivational and de-motivational scores were 3.65 and 2.51, respectively. The median cognitive category score was 27 (maximum score 35) while the motivation score was 26 (maximum score 35) and the de-motivational score was 12 (maximum score25). There was no significant difference in scores according to respondents' demographic characteristics. CONCLUSION Student perception about small group effectiveness was positive. Since most medical schools worldwide already have or are introducing PBL as a learning modality, the Tutorial Group Effectiveness Instrument can provide valuable information about small group functioning during PBL sessions.
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Affiliation(s)
- P Ravi Shankar
- Departments of Pharmacology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Atanu Nandy
- Departments of Microbiology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Ramanan Balasubramanium
- Departments of Pathology, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
| | - Soumitra Chakravarty
- Departments of Biochemistry, Xavier University School of Medicine, Aruba, Kingdom of the Netherlands
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Jha N, Rathore DS, Shankar PR, Gyawali S. Pharmacovigilance Knowledge among Patients at a Teaching Hospital in Lalitpur District, Nepal. J Clin Diagn Res 2014; 8:32-4. [PMID: 24783073 PMCID: PMC4003677 DOI: 10.7860/jcdr/2014/7378.4097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 12/31/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Consumer's knowledge and perception towards adverse drug reactions (ADR) can play an important role in ensuring a healthy lifestyle and proper use of medicines. AIMS This study aimed to assess the knowledge and perception towards pharma covigilance in general and consumer pharmacovigilance in particular among out patients in a teaching hospital of Nepal. SETTINGS AND DESIGN A descriptive cross-sectional study using qualitative and quantitative methods was carried out from 1(st) May to 3 June 2013. METHODS Every fifth patient visiting the outpatient pharmacy was interviewed using a semi-structured questionnaire. Gender, age, educational qualification, profession and ethnicity were noted. Twenty-three patients were interviewed. RESULTS There were 10 males and 13 females. The age of the respondents ranged from 11 to 50 years with a mean age of 27.8 (SD = 5.61) years. Seven (30.43%) respondents were students studying in different levels. Thirteen (56.52%) participants were from the Newar community. Majority of the patients (86.95%) knew ADRs may be caused by the medicines they consume and 18 (78.26%) were of the opinion that ADRs should be reported to doctors and other health care professionals including pharmacists. CONCLUSION Knowledge and perception were low in certain areas. There is a need for educational interventions for improving the awareness of patients and general public for ensuring medicine safety and promoting rational use of medicines.
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Affiliation(s)
- Nisha Jha
- Lecturer, Department of Clinical Pharmacology and Therapeutics, KIST Medical College, Imadol, Nepal and PhD Research Scholar, Suresh Gyan Vihar University, Jaipur, India
| | | | - P Ravi Shankar
- Professor, Department of Pharmacology, Xavier University School of Medicine, Santa Helenastraat, Aruba, Dutch, Caribbean
| | - Sudesh Gyawali
- Assistant Professor, Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal and PhD Research Scholar, Suresh Gyan Vihar University, Jaipur, India
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