Assessment of medication prescription errors and their contributory factors in major cities of Punjab Province, Pakistan: A cross-sectional survey

Purpose: To evaluate the prescription errors and their contributory factors in Punjab, Pakistan.Methods: An observational, cross-sectional study was conducted in 12 major cities of Punjab, Pakistan. A total of 1,184 prescriptions were collected from patients using a convenient sampling method from homes, pharmacies, clinics, and hospitals. The data were presented in frequency and percentage using descriptive statistics. To determine the association between the variables assessed, Chi-square (X2) test was used.Results: A total of 1,184 prescriptions were analyzed; 432 of them (36.5 %) were from prescribers who are graduate degree holders, and 752 (63.5 %) from prescribers who are post-graduate degree holders. The most commonly missing parameters in the prescriptions were the age of the patients (835 representing 29.4 %), signatures of the prescribers (755 representing 26.5 %), and prefix (622 representing 21.9 %). The number of prescription errors was significantly correlated to prescriber qualification (p = 0.001). The prescription errors were more common in age groups of prescribers: 21 - 30 years (654 representing 23.0 %), and 31 - 40 years (1,012 representing 35.6 %) (p = 0.001). The higher number of prescription errors by post-graduate prescribers working in teaching hospitals can be attributed to the higher patient load and lack of continuing medical education programs for the prescribers.Conclusion: The government should take necessary measures for the implementation of electronic prescribing systems, and devise mechanisms for the uniform distribution of patient load amongst the prescribers working in different hospitals. Keywords: Prescription error, Prescribers, Patient load, Continuing medical education, Electronic prescribin

Extra-biliary complications during laparoscopic cholecystectomy: How serious is the problem?

<b>Objective:</b> To deteremine the incidence, nature and management of extra-biliary complications of laparoscopic cholecystectomy. <b>Materials and Methods:</b> This study presents a retrospective analysis of extra-biliary complications occuring during 1046 laparoscopic cholecystectomies performed from August 2003 to December 2006. The study population included all the patients with symptomatic gallstone disease in whom laparoscopic cholecystectomy was performed. The extra-biliary complications were divided into two distinct categories: (i) Procedure related and (ii) Access related. <b>Results:</b> The incidence of access-related complications was 3.77&#x0025; and that of procedure-related complications was 6.02&#x0025;. Port-site bleeding was troublesome at times and demanded a re-do laparoscopy or conversion. Small bowel laceration occurred in two patients where access was achieved by closed technique. Five cases of duodenal and two of colonic perforations were the major complications encountered during dissection in the area of Calot&#x2032;s triangle. In 21 (2&#x0025;) patients the procedure was converted to open surgery due to different complications. Biliary complications occurred in 2.6&#x0025; patients in the current series. <b>Conclusion:</b> Major extra-biliary complications are as frequent as the biliary complications and can be life-threatening. An early diagnosis is critical to their management

Extra-biliary complications during laparoscopic cholecystectomy: How serious is the problem?

Objective: To deteremine the incidence, nature and management of extra-biliary complications of laparoscopic cholecystectomy. Materials and Methods: This study presents a retrospective analysis of extra-biliary complications occuring during 1046 laparoscopic cholecystectomies performed from August 2003 to December 2006. The study population included all the patients with symptomatic gallstone disease in whom laparoscopic cholecystectomy was performed. The extra-biliary complications were divided into two distinct categories: (i) Procedure related and (ii) Access related. Results: The incidence of access-related complications was 3.77% and that of procedure-related complications was 6.02%. Port-site bleeding was troublesome at times and demanded a re-do laparoscopy or conversion. Small bowel laceration occurred in two patients where access was achieved by closed technique. Five cases of duodenal and two of colonic perforations were the major complications encountered during dissection in the area of Calot′s triangle. In 21 (2%) patients the procedure was converted to open surgery due to different complications. Biliary complications occurred in 2.6% patients in the current series. Conclusion: Major extra-biliary complications are as frequent as the biliary complications and can be life-threatening. An early diagnosis is critical to their management