Science Attitudes and Knowledge among Preclinical Medical Students in Pokhara, Nepal

Knowledge of science and the scientific method are important in learning about and using evidence-based medicine in practice. Courses in research methodology have been introduced for both medical students and practicing doctors. In Pokhara, the basic science subjects are taught in an integrated manner during the first four semesters of the undergraduate medical course. Studies on students’ attitudes towards and knowledge of science are lacking in medical colleges in Nepal. Hence the study was carried out to obtain information on students’ attitude towards and knowledge of science and scientific methodology among preclinical medical students and note the association, if any, of students’ attitudes and their demographic characteristics. The study was carried out in March 2005 among the students of the first four semesters at the Manipal College of Medical Sciences, Pokhara, Nepal using a questionnaire developed by Hren and coworkers. Two hundred and twenty students (overall response rate 73.3%) successfully completed the questionnaire. Seventy- five respondents were Nepalese, 115 were Indians, 27 were Sri Lankans and 3 belonged to other nationalities. The X±SD total attitude score was 147.4±10.8 (neutral score 135). The X±SD scores on the subscales, value of science to humanity, value of scientific methodology and value of science to medicine were 51.3±5.4, 39.6±3.7 and 58.5±5.9 (neutral scores were 36, 51 and 48 respectively). The knowledge score measured using a set of 8 multiple choice questions was 3.3±1.4. The attitude scores were lower and the knowledge score was comparable to that reported previously in a study in Croatia but higher than that reported from Southeast Europe

Impact of educational outreach visits by pharmacists on treatment of childhood diarrhoea-initial findings from Banke district, Nepal

Diarrhoea is one of the most common causes of mortality and morbidity in children in developing countries. Oral rehydration salts (ORS) and zinc are the primary tools used to fight diarrhoea in children. Educational outreach visits or academic detailing has been practiced over a period of time to improve prescribing behaviour in the developed countries. However, educational outreach programmes are very uncommon in Nepal. We conducted a pilot study to see the impact of educational outreach visits on the management of diarrhoea in children among 10 prescribers in the Banke district of Nepal. Initial findings suggest that there is a marked improvement on the prescribing of ORS and zinc by the prescribers after our intervention. Therefore it is planned to conduct the same study among a large number of prescribers in the Banke district of Nepal

Academic detailing as a possible source of drug information in the context of Nepal: a short review

The source of unbiased drug information is an integral part of evidence based practice. The status of evidence based practice in Nepal is very poor. One of the major factors associated with it, is the limited availability of new literature, and poor documentation and dissemination of the little available information. Academic detailing is an educational outreach program in which a trained health professional visits clinicians in their offices to provide evidence based information. So, there is a huge scope for academic detailing as a means to disseminate the available information in the context of Nepal. Research done worldwide has already shown improvement in the clinicians’ knowledge, their attitude and practice, improvement in their prescribing patterns and an increase in their adherence to clinical guidelines, following academic detailing. In Nepal, there are many topics which can be selected for academic detailing. Topics covering the information regarding newer drugs, diarrhoea treatment guidelines, the rational use of antimicrobials, the rationality of fixed dose combinations, nonsteroidal antinflammatory drugs (NSAIDs) and specialized devices for the administration of drugs, will be more relevant. Lack of local health statistics, lack of awareness about evidence based practice, challenges from pharmaceutical representatives and a lack of financing capability may be the major limitations for academic detailing in Nepal

Clinical profile and drug utilization pattern in an intensive care unit of a teaching hospital in western Nepal

To analyze the clinical profile of patients admitted to the intensive care unit (ICU) of Manipal Teaching Hospital (MTH) at Pokhara, Nepal, identify the commonly prescribed drugs, drug categories, dosage forms, antimicrobials, sensitivity pattern of antimicrobials and the treatment outcomes. A cross sectional, descriptive study in which he case records of all the patients admitted in the ICU during 1st August to 30th September, 2007 were collected and the details were entered in the patient profile form. The filled patient profile forms were retrospectively analyzed as per the study objectives. Altogether, 201 patients [males 101 (50.25%)] were admitted. Most common diagnosis was 'Myocardial Infarction /Ischemic heart disease' [13.96 % (n=62)]. The median (interquartile range) of the ICU stay was 3 (2-4) days. Cardiovascular drugs [31.7% (n=761) were the most commonly prescribed. Among the antimicrobials, metronidazole was most commonly prescribed followed by ceftriaxone. The morality rate in the ICU was 17.41 % and the major causes of mortality were cardiovascular and respiratory diseases. Antimicrobials was the most common drug category used in the ICU and 'pantoprazole' was the most commonly prescribed individual drug. Cardiovascular and respiratory diseases were major causes of death in the ICU

Personal Drug Selection: Problem-Based Learning in Pharmacology: Experience from a Medical School in Nepal

BACKGROUND: At the Manipal College of Medical Sciences, Pokhara, Nepal, Pharmacology is taught during the first four semesters of the undergraduate medical course. Personal or P-drug selection is an important exercise. The present study was carried out to obtain student opinion about the P-drug learning sessions, the assessment examinations, and on the small group dynamics. METHOD: The practical sessions on P-drug selection are carried out in small groups. Student feedback about the session was obtained using focus group discussions. The focus groups were selected to represent both genders and the three main nationalities, Nepalese, Indians, and Sri Lankans. There were four Nepalese, five Indians, and three Sri Lankans. Within each nationality and gender category the students were randomly selected. The respondents were explained the objectives of the study and were invited to participate. Written informed consent was obtained. The discussion lasted around two hours and was conducted in the afternoon in two groups of six students each. The first author (PRS) acted as a facilitator. The responses were recorded and analyzed qualitatively. RESULTS: The overall student opinion was positive. Around 25% (3 respondents) of respondents were confused about whether P-drugs were for a disease or a patient. Group consensus was commonly used to give numerical values for the different criteria. The large number of brands created problems in calculating cost. The students wanted more time for the exercise in the examination. Formative assessment during the learning sessions may be considered. The group members usually got along well. Absenteeism was a problem and not all members put in their full effort. The physical working environment should be improved. CONCLUSIONS: Based on what the students say, the sessions on P-drugs should be continued and strengthened. Modifications in the sessions are required. Sessions during the clinical years and internship training can be considered

A research methodology workshop on ‘Social issues in use of medicines’ – cooperation between institutions and participant feedback

A research methodology workshop on social issues in use of medicines was conducted at Pokhara, Nepal from December 21st to 24th, 2008. The present study was conducted to obtain detailed participant feedback about the workshop and obtain suggestions for improvement. The participants’ knowledge was assessed at the start of the workshop and on the final day by noting their agreement with a set of 40 statements using a modified Likert-type scale. The areas of qualitative research, statistics, research methodology, drug use, pharmacovigilance, journal and general were covered. Certain statements were negative and their scores were reversed. The total score was calculated. The median total scores were compared among various subgroups of respondents. Session evaluation was done at the end of each session. A total of twenty-five participants attended the sessions. The workshop significantly improved the median total scores. Significant improvements were also seen in the subcategories Statistics and Journal. The scores of certain statements were low. The evaluation scores of certain sessions were low. The overall participant opinion about the workshop was positive. Occasional problems with accent of the facilitator and lack of internet access were major problems noted. Some participants felt the workshop was too hectic. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 60-67 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6829</a