Understanding and Analyzing Prescribing and Prescription Errors in Outpatient Setting of a Medical College Hospital ENT Department

Introduction A medication error is a failure in the treatment process that leads to, or has the potential to lead to, harm to the patient. In the hospital OPD, errors can occur in deciding on the medication to be prescribed (prescribing error) or in writing the prescription (prescription error). Materials and Methods We analyzed 100 prescriptions and case sheets in the OPD of ENT department in a tertiary medical college hospital for a period of one week for errors and assessed the perceptions and attitudes of the residents of the department using a questionnaire. Result Several prescription writing errors were found, primarily failure to document non pharmaceutical patient advice and use of generic names. Four prescribing errors were noticed which did not need urgent intervention. Discussion Failure modes and effects analysis was done to rank the failures modes; and causes for failure were elucidated using Ishikawa Diagram. Recommendations for preventing errors were made based on these results. Conclusion This study illustrates the use of management techniques to identify errors and formulate appropriate preventive responses. Such techniques should be a part of ongoing departmental management; and they provide insights into improving resident training in an ENT residency program

Mucormycosis: Effect of Comorbidities and Repeated Debridement on the Outcome

Introduction: Mucormycosis is an aggressive, invasive infection caused by ubiquitous filamentous fungibelonging to the subphylum Mucormycotina, order Mucorales. Mucormycosis most commonly affects immunocompromised hosts, but are rarely reported in immunocompetent hosts as well. The most common reported sites of invasive mucormycosis have been the sinuses (39%), lungs (24%), and skin (19%). The hallmark of mucormycosis is angioinvasion resulting in vessel thrombosis and hence, tissue necrosis.   Materials and Methods: Ambispective study of 20 cases with mucormycosis seen and treated in our hospital between 2009 and 2015 and followed up to 2017 to compare the prognosis of the cases of repeated debridement with that of single debridement and effect of comorbidities in the outcome of patients mortality .   Results: Out of 20 patients 19 (95%) received Liposomal Amphotericin B. 11 (55%) were male and 9 (45%) were female. All the 7 (35%) who underwent repeated debridement survived. Out of 13 (65%) patients who underwent single debridement, 5 (25%) did not survive. 2 (10%) patients were lost for follow up. The survival amongst the patients undergoing multiple debridement and single debridement was statistically significant (p=0.042) Conclusion: The chances of survival are better in cases with better controlled comorbid conditions like diabetes mellitus. Repeated debridement with Liposomal Amphotericin B is the most effective mode of management

Mucormycosis: Effect of Comorbidities and Repeated Debridement on the Outcome

Introduction: Mucormycosis is an aggressive, invasive infection caused by ubiquitous filamentous fungibelonging to the subphylum Mucormycotina, order Mucorales. Mucormycosis most commonly affects immunocompromised hosts, but are rarely reported in immunocompetent hosts as well. The most common reported sites of invasive mucormycosis have been the sinuses (39%), lungs (24%), and skin (19%). The hallmark of mucormycosis is angioinvasion resulting in vessel thrombosis and hence, tissue necrosis.   Materials and Methods: Ambispective study of 20 cases with mucormycosis seen and treated in our hospital between 2009 and 2015 and followed up to 2017 to compare the prognosis of the cases of repeated debridement with that of single debridement and effect of comorbidities in the outcome of patients mortality .   Results: Out of 20 patients 19 (95%) received Liposomal Amphotericin B. 11 (55%) were male and 9 (45%) were female. All the 7 (35%) who underwent repeated debridement survived. Out of 13 (65%) patients who underwent single debridement, 5 (25%) did not survive. 2 (10%) patients were lost for follow up. The survival amongst the patients undergoing multiple debridement and single debridement was statistically significant (p=0.042) Conclusion: The chances of survival are better in cases with better controlled comorbid conditions like diabetes mellitus. Repeated debridement with Liposomal Amphotericin B is the most effective mode of management