Comparative study of patient-based versus case-based teaching in prescription writing skills of second year MBBS students

Background: Prescription writing errors can lead to deficiencies in healthcare. Although prescription writing is a part of the medical students' curriculum with traditional methods, their prescribing skills are still poor due to inadequate training. To fulfil the need for new educational interventions this study aims to compare patient-based teaching with case-based teaching in improving prescription writing skills of second year MBBS students.Methods: This prospective comparative study was carried out after orientation of participants to prescription writing as per WHO prescribing guidelines (n=71). Group A (n=37) and group B (n=34) were given patient-based teaching and case-based teaching respectively of prescription writing for the same five common clinical conditions. The prescription writing skill was assessed by evaluating the prescriptions written by both the groups and scored by 19-point scoring system. Feedback from the group A students was also taken.Results: Statistical analysis of mean scores of group A (15.90) and group B (13.14) was done by Mann-Whitney U test (p<0.001). Comparison of both the groups for the individual parameters was done by Chi-square test which found significant difference in writing some important parameters like doctor’s registration no., contacts of prescriber, name of the medicine, strength of drug, dosage form, dosing instructions, total quantity of medicine and duration of medication etc. Group A students’ feedback brought out the fact that patient-based teaching is a good tool for teaching and learning.Conclusions: Patient-based teaching for prescription writing improves students’ prescription writing skills in an effective way in comparison with traditional case-based teaching

Assessment of efficacy and safety of artesunate plus sulfadoxine pyrimethamine combination for treatment of uncomplicated falciparum malaria

Background: Resistance of Plasmodium falciparum to antimalarial drugs is common in India. World Health Organization (WHO) recommends artemisinin‑based combination therapy (ACT) to counter the development of resistance in P. falciparum. WHO recommends that ideally antimalarial drug treatment policy or guidelines should be reviewed regularly and updated at least once every 24 months. In consideration to the above recommendation, we planned to conduct the following study. The objective was to determine the efficacy and safety of artesunate + sulphadoxine‑pyrimethamine (AS + SP) in patients with uncomplicated P. falciparum malaria.Methods: The study included 60 patients of uncomplicated P. falciparum. Each patient received AS + SP as per WHO guidelines. Diagnosis was confirmed by peripheral blood film. All patients were followed‑up on days 1, 3, 14, and 28 for detailed clinical and parasitological examination.Results: Of a total 60 patients, 55 patients were followed‑up for 28 days. Remaining 5 patients were lost in follow‑up. As per protocol analysis, 91% (50) of patients had demonstrated adequate clinical and parasitological response. Remaining 9% (5) had treatment failure in which 5.5% (3) had late parasitological failure and 3.6% (2) had late clinical failure. In our study, mean parasite clearance time was 45.2 ± 4.2 hrs.Conclusion: AS + SP is safe and effective drug for the treatment of uncomplicated falciparum malaria. However, the efficacy of this ACT needs to be carefully monitored periodically since treatment failure can occur due to resistance

Effect of gabapentin on haloperidol induced inhibition of conditioned avoidance response in rat

Background: Haloperidol, an antipsychotic adversely affects acquisition and retention of a learned task. We decided to test the effect of Gabapentin, a new anti-epileptic drug using conditioned avoidance response model with cook’s pole climbing apparatus and haloperidol.Methods: Four groups of six rats were taken for this purpose. All the rats were first given drugs for five days and then trained for a period of 15 days. Gabapentin was given in a dose of 100mg/kg intra peritoneal, while haloperidol was given 0.5mg/kg intra peritoneal.Results: At the end of the training duration rats in the vehicle and gabapentin treated group achieved ≥85% acquisition responses. While the haloperidol and haloperidol + gabapentin group did not achieve the desired percentage of learning. A learning curve was plotted by using the percentage of conditioned responses in each group versus number of days. The mean ± SD percentage of conditioned responses of day 14 and 15 were for haloperidol group 26.19 ±11.90, for vehicle group 86.90 ± 4.29, for the gabapentin treated group 95.24 ± 2.38 and for the gabapentin + haloperidol group 46.42 ± 12.20. These figures and the learning curve suggest that gabapentin treated rats had a better acquisition response and haloperidol depressed learning.Conclusions: At the end of study duration we found that gabapentin significantly improved the acquisition response than the vehicle control group. Also haloperidol depressed the acquisition response. Gabapentin did not lead to reversal of haloperidol induced depression of acquisition process

An observational comparative study of clinical efficacy and safety of chlordiazepoxide and lorazepam in alcohol withdrawal syndrome

Background: Currently, Benzodiazepines like chlordiazepoxide, diazepam and lorazepam are the preferred drugs in the management of Alcohol withdrawal syndrome (AWS). These drugs of similar class are different in their pharmacokinetic profile which differently affect in AWS. Chlordiazepoxide is longer acting and converted to active metabolites in the liver, while lorazepam is shorter acting, with no active metabolites. Materials and methods: An observational, prospective and comparative study conducted in 100 patients of AWS. They received either Chlordiazepoxide or Lorazepam and divided into two comparison groups at the screening. Observation was started from day of admission to every day till day of discharge. The initial withdrawal assessment and subsequent changes in withdrawal during treatment were assessed using the Clinical Institute Withdrawal Assessment for Alcohol scale, revised (CIWA-Ar) in both the groups. Clinical global impression (CGI) score was also used to evaluate drug efficacy in both the groups. Details of adverse drug reactions, if any appear were recorded. Results: CIWA-Ar score, CGI-Severity (CGI-S) score and CGI-Improvement (CGI-I) score showed statistically significant difference between two groups. But percentage reduction in CIWA-Ar, CGI-S and CGI-I score were almost similar in both groups. Intra group comparison at different duration of treatment progressed and in between days of treatment there was statistically significant reduction of these scores. Considering no. of adverse events, reported adverse events causality, severity, predictability and preventability assessment, both drugs were safe. Conclusion: Both the drugs had almost similar efficacy in terms of to reduce CIWA-Ar score, CGI-S score, CGI-I score and similar safety profile