The Approach of Pharmacy Students Towards Communication of Medication Errors in Karachi, Pakistan

Purpose: To assess pharmacy students’ knowledge of communicating medication errors in Karachi, Pakistan.Methods: The study design was cross-sectional and conducted from February to May 2014. A previously validated questionnaire was adopted, modified and distributed to final year pharmacy students in four universities of Karachi. Descriptive statistics were used to present students’ demographic information and their response to the questionnaire items. Pearson chi square test and Logistic regression model were executed to evaluate the association of gender and institution of students with their response.Results: Out of 600 survey questionnaires distributed, only 464 were returned in useable form, giving a response rate of 77.33 %. A majority of the students showed moderately positive attitude towards general communication and training in communicating medication errors. More than 40 % of the respondents were not satisfied with the training they received in communicating and reporting incidence of medication errors. Incorrect drug (14.65 %), incorrect dose (8.40 %) and improper storage of medicines (7.97 %) were the most common errors observed by the students during clerkship.Conclusion: The findings indicate the need for a more standardized approach to improving knowledge of medication errors as well as training in the communication of occurrence of medication errors.Keywords: Communication, Medication error, Pharmacy students, Standardized trainin

CURATION AND MANAGEMENT OF CULTURAL HERITAGE THROUGH LIBRARIES

Libraries, museums and archives hold valuable collections in a variety of media, presenting a vast body of knowledge rooted in the history of human civilisation. These form the repository of the wisdom of great works by thinkers of past and the present. The holdings of these institutions are priceless heritage of the mankind as they preserve documents, ideas, and the oral and written records. To value the cultural heritage and to care for it as a treasure bequeathed to us by our ancestors is the major responsibility of libraries. The past records constitute a natural resource and are indispensable to the present generation as well as to the generations to come. Libraries preserve the documentary heritage resources for which they are primarily responsible. Any loss of such materials is simply irreplaceable. Therefore, preserving this intellectual, cultural heritage becomes not only the academic commitment but also the moral responsibility of the librarians/information scientists, who are in charge of these repositories. The high quality of the papers and the discussion represent the thinking and experience of experts in their particular fields. The contributed papers also relate to the methodology used in libraries in Asia to provide access to manuscripts and cultural heritage. The volume discusses best practices in Knowledge preservation and how to collaborate and preserve the culture. The book also deals with manuscript and archives issues in the digital era. The approach of this book is concise, comprehensively, covering all major aspects of preservation and conservation through libraries. The readership of the book is not just limited to library and information science professionals, but also for those involved in conservation, preservation, restoration or other related disciplines. The book will be useful for librarians, archivists and conservators. We thank the Sunan Kalijaga University, Special Libraries Association- Asian Chapter for their trust and their constant support, all the contributors for their submissions, the members of the Local and International Committee for their reviewing effort for making this publication possible

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Social Media and Body Dysmorphic Disorder (BDD): Is There Any Link?

To the Editor, Body Dysmorphic Disorder (BDD) is defined as a persistent and intrusive preoccupation with a non-existent or slight imperfection in one’s appearance. Being labelled as one of the obsessive-compulsive and related disorders, it has multifactorial etiology like cognitive deficits, psychological impairment and neurochemical abnormalities. However, a 2020 study has shed light on a  more serious concern- it showed that the use of social media for longer duration, especially Snapchat and Instagram, are associated with increased incidence of BDD distinctly in young participants.1 Other researches have also highlighted this that social media can kindle the negative belief of body image by circulating photos, videos and comments about ideal self-image triggering  insecurities especially in youngsters, about their physical features, body shape,  complexion etc.2,3  Furthermore, social media platforms like Snapchat and Instagram are specialized in photo and video editing features, a behavior that is common in people with BDD.4 Fantasizing the celebrity ideals and social media influencers has promoted body dissatisfaction, disordered eating and other psychological comorbidities resulting in more frequent dermatological and psychiatric consultations.1 According to WHO approximately 24 million people in Pakistan need psychiatric assistance. Mental illness and psychological disorders still face persistent social taboo here. As only one psychiatrist is present for every 10,000 people in the country, BDD can become a big problem for the already feeble health system here by increasing the burden of mental illnesses. People here already consider white complexion the epitome of beauty and success, and promotion of similar mentality through social media either by celebrities or by influencers can be disastrous for the mental health of young individuals. That is why it is mandatory to dictate the proper and constructive use of social media. Facebook and Twitter trends can be set up for awareness and encouraging natural beauty instead of perfectly filtered dummy faces. As celebrities and influencers are followed by many, social media sites should promote people because of their intellect, talent and hard work rather than their appearances. These trivial steps can play a pivotal role in decreasing body dissatisfaction and concerns

Is Dapagliflozin future for CKD?

Dapagliflozin belongs to the latest class of anti-diabetic medication Sodium-glucose co-transporter two inhibitors (SGLT2i). The drug is mainly used in type 2 diabetes (T2D) by preventing the reabsorption of glucose in the proximal tubule of the kidney causing glycosuria and regulating blood glucose levels. It is a well-tolerated drug with rare side effects including hypoglycemia, diabetic ketoacidosis, genital and urinary tract infections. The drug gain popularity through its effect in lowering cardiovascular and renal events in patients with T2D through mechanisms independent of lowering blood glucose levels. (1) Adding to its benefits, Wheeler et al stated that Dapagliflozin decreases the risk of renal and cardiovascular events and reduces overall mortality in diabetic and  non-diabetics with chronic kidney disease (CKD). Reduction in non-cardiovascular deaths was the critical factor to improve the mortality rates, most common among which were infections and malignancies. (3) Another 2021 publication of the European Heart Journal also showed that Dapagliflozin significantly reduces  mortality in patients suffering from CKD with or without type 2 diabetes. Reduction in non-cardiovascular deaths was the key factor in  improving the mortality rates, most common among which were infections and malignancies. (4) The prevalence of CKD in South Asian countries is relatively high. Pakistan tops the list with the highest prevalence of 21.2%. (4) Dapagliflozin has been approved for use in Pakistan in the year 2017.(5) Also, the more compelling pieces of evidence and greater recognition of CKD, and greater use of SGLT2 inhibitors in non-diabetics in clinical practice are imperative for the many people who stand to benefit from longer and healthier lives. The drug is opening new horizons for the treatment of CKD. Continue.

Medical students’ perception toward neurosurgery as a career: a cross-sectional study

Abstract Background This study aims to access the perspective of medical students toward practicing neurosurgery after MBBS and also to identify factors responsible for low affinity among medical students in pursuing neurosurgery as a career. In this cross-sectional study, medical students were surveyed via pre-tested questionnaire, with a four-point Likert scale to determine their influence on student’s consideration of neurosurgery as a career. Data analysis was performed using SPSS software. Results The survey was completed by 185 students out of which 56.2% students considered neurosurgery as a career. Although more than 90% students acknowledged that neurosurgery training is too prolonged and it can also impede family life but huge prestige and income is attached to neurosurgery, 35.7% students shared that neurosurgery exposure and teaching is not adequate enough for them in order to have a positive influence toward neurosurgery as a career. Conclusion Additional studies are required to further explore how participation in a formal neurosurgery experience can alter medical students’ perceptions and influences their consideration of neurosurgery as career choice