The identification of drug related problems (DRPs) using profilaxis antibiotics in orthopedic surgical patients at a Government Hospital in Yogyakarta

Background: Antibiotic prophylaxis in orthopedic surgery cases aims to prevent surgery site infections (SSI). For antibiotic prophylaxis, it is recommended to use the first generation of cephalosporin, namely cefazolin which can kill the bacteria commonly found in orthopedic surgery infection. The prophylactic administration of cefotaxime is not the first line but is definitive for surgical prophylaxis. Objective: The aim of this study was to determine the rationale for the use of antibiotic prophylaxis for orthopedic surgery, the drug problems (DRPs) that occurred and their potential interactions. Method: This study was conducted using a cross sectional design with a total sampling technique of medical record samples from January to February 2019 at the Government Hospital in Yogyakarta. Observational analytical descriptive data processing by ensuring the appropriate of indications, route of administration, timing of administration and an appropriate of prophylactic doses as well as how to compare DPRs to the literature and analysis of potential co drug interaction with Drug Information Handbook (DIH), AHFS Clinical Drug Information, Drug Interaction Facts, and Interactions Stockley’s Drug Interaction. Results: All patients received appropriate therapy for indication, type of drug, routes of administration for pre and postoperative. All patients received an under dose of ranitidine and 1 patient (1,69%) received an over dose of piracetam. Potential interactions that occur include ketorolac-ranitidine, NSAIDs with other NSAIDs, NSAIDs-ranitidine, NSAIDs-ACEi, NSAIDs-bisoprolol, bisoprolol-calcium, calcium-vitamin C, and paracetamol-ranitidine. Conclusion: Pre and postoperative prophylactic antibiotics are rational. The accompanying drug, ranitidine and piracetam were not properly doses. Drug interactions in this study are potential. Keywords: prophylaxis antibiotic, orthopedic surgery, cefotaxim, DRPs

Maternal Experiences of Home-based Kangaroo Mother Care Following Discharge from a Rural-Urban Health Facility, Nsawam Government Hospital, Ghana

Background: Preterm birth (PTB) is the leading cause of child mortality worldwide and Sub-Saharan Africa is disproportionately affected. Inadequate access to cost-effective interventions in most poor resource areas threatens to increase preterm birth related mortalities. Kangaroo mother care has proven to be a cost-effective intervention and has reduced death as a result of complications of PTB by half. Purpose: This study therefore sought to explore and document the experiences of mothers regarding KMC following discharge from Nsawam Government Hospital. Methods: An exploratory descriptive design was used to collect data from mothers who had preterm births and their experiences of practicing kangaroo mother care at home. Fourteen participants in the Nsawam municipality were purposively selected to participate in the study. Data was analyzed using inductive thematic analyses. Findings: The findings of the study indicated that mothers are encouraged to practice KMC based on the benefits of KMC like provision of warmth, bonding and improvement in growth and development. The study also indicated that support systems available to mothers at home included family, churches, community and healthcare providers. Recommendations: The study recommended that; proper follow-up care should be undertaken by clinicians on mothers practicing KMC especially in their respective home environment to ensure adherence KMC practice experiences in the home.

A study on the morbidity profile of children under 5 years of age and knowledge of parents regarding their health seeking behavior

To study the morbidity profile of children under 5 years of age and knowledge of parents regarding their health seeking behavior. The study was a community based cross-sectional study. The study was conducted in the Field practice area of Rural Health Training Centre (RHTC) of Hind Institute of Medical Sciences, Barabanki. Families with at least one under five-year child, all family willing to participate and consenting and families residing in the study site for the minimum last 1 year were included in the study. A total of 400 subjects were included in the study. Door to door visit was done for data collection. Morbidity was almost nil in 0-2 months preceding the interview. Diarrhoea was most common morbidity during 2 months – 5 years preceding the interview. Government hospital for treatment was preferred by 53.5% of the respondents. Treatment at government hospital was taken by 55% of the respondents. Secondary level of care was available in 50.2% of the respondents. Only 2.2% of the respondents reported any problem with the treatment. Hospital was visited by 65% of the respondents for the treatment. Child’s last illness was 3-6 months in 52.8% of the respondents and Diarrhoea was the most common type of illness. 62.8% of the respondents visited government hospital for the treatment of child. More than one third of respondents visited health facility by bicycle (42.8%) and 24.5% approached by walking. Time taken to reach health facility was 15-30 minutes in 51% of the respondents. The main reason to choose particular health facility was Trust over the provider of the facility (41.5%). This study demonstrates the importance of maternal perception of illness severity in determining facility based care seeking for childhood illness in rural area.

Effectiveness of short duration phototherapy in government hospital setup

Background: Neonatal hyperbilirubinemia is most common presentation of neonates. Phototherapy remains standard treatment for neonatal hyperbilirubinemia. Overcrowding in government hospital makes it difficult to give phototherapy for more than 1-2 days. The objectives of the study were to determine the effectiveness of short duration of phototherapy in treating hyperbilirubinemia and to determine the risk of rebound hyperbilirubinemia.Methods: Study was hospital based retrospective study. The study place was GIMS kalaburagi. The study was conducted from September 2019 to December 2019. All healthy full-term neonates with serum bilirubin above cut off range according to (American academy of pediatrics) nomogram were included in the study. Requirement of phototherapy was decided on serum bilirubin levels as per AAP (American academy of pediatrics) nomogram. Phototherapy was used as treatment modality.Results: Total 110 neonates were included in the study. Total of 56 neonates (50.9%) required 1 day of phototherapy to fall within normal limits for discharge and 46 neonates (41.8%) required 2 days of phototherapy to fall within normal limits for discharge with a significant p<0.05. Rebound hyperbilirubinemia requiring repeat phototherapy was seen in 6(10%) neonates who were discharged after 1 day of phototherapy and in 5 neonates (10%) who were discharged after 1 day of phototherapy with a p value of 0.05.Conclusions: Short duration phototherapy is the effective means of treatment for most neonates in government hospital set up. Serum bilirubin has to be reviewed during follow up to assess rebound hyperbilirunemia.

Son Preference in India

Through a focus on Rajasthan, this chapter analyses how government awareness campaigns for gender equality, as well as a sharp rise in institutional deliveries throughout the country in the 2000s, have affected how son preference is discussed and treated in hospitals. Drawing on 3 months of ethnographic fieldwork in a government hospital in Jaipur, this chapter shows that the condemnation of son preference has enhanced regimes of medical and moral surveillance within obstetric wards. Not only does it contribute to further castigation and self-disciplining mechanisms, but it also constitutes a new opportunity for social distinction. While condemning son preference practices, women, nurses, and doctors are constantly finding scapegoats in social classes, state, and generational differences. Thus, this chapter considers whether the public condemnation of son preference, currently jeopardizing the relationship of trust between caregivers and patients, could undermine government policies on safe motherhood.

From Medicalizing State to Sacralizing Status of Thai Buddhist Monks in Secular Space: A Case Study of the Priest Hospital

This paper examines the sacred status of Thai Buddhist monks who have been engaging with the modern secular healthcare system, which also contrasts with their monastic traditions. It questions how modern medication has affected the sacred figure of Thai monks and what is their reaction to maintain their sacred status in such a secular space? Participant observations and informal interviews have been conducted, and data are conceptualized through the ideas of the birth of the clinic and biopower proposed by Michel Foucault. It finds that the traditional healing previously played by Thai monks has been challenged by modern medication eventually the monks also access the modern hospital. This phenomenon helps to change the idea of the cause of sickness, from demons to germs. This is interesting when some Buddhists request the monastic code-based healthcare system and monk patients’ zone. This paper argues that such an effort aims to maintain the sacred status of monks, who are perceived as holy persons and should not be seen by laypeople especially when they are in sickness, pain, and sorrow, which portray their ordinary human natures. Therefore, zoning management in the government hospital is needed to sacralize the monks’ status.

Assess the Stress Level among Spouses of Alcoholics and Spouses of Non- Alcoholics in a Hospital at Avadi, Chennai

The addiction leads to the usage of unconscious purposive abused substances like alcohol and these harms to the self, family and society also. Most of the abuse substances result in mental instability such as depression, major personality disorder, anxiety disorders and dysthymia. The alcoholism is the predominant abused compound and makes very harder life in India and throughout worldwide. Among them, their spouses are most affected beings than any others and they face severe negative impacts on mental and physical health. The present study aimed to analyses the stress created and the successive management in alcoholic spouses compared to the wives of non- alcoholics. The non-experimental, comparative study was includes totally, 70 women (alcoholic and non- alcoholic spouse, 35 each) using non-possibility convenient sampling method at a government hospital, Chennai, Tamil Nadu.The analysis was done using geographical, demographical variations and stress was assessed based on the Sheldon Cohen parameters. The data was collected and statistically evaluated. The study was framed based on Betty Newman system theory. The study also showed that the spouses of alcoholics faced severe stress level due to domestic violence. This study also showed that .they need adequate medical and psychological care from society.

Perception of Pain Management Among Nurses: A Study at Enchi Government Hospital

The subjective nature of pain makes it difficult to manage, especially when your healthcare personnel (mostly nurse) does not have requisite knowledge on pain management. Thus, the purpose of the study is to investigate the perception of pain management among nurses at Enchi Government Hospital. Descriptive cross-sectional study design with quantitative approach and convenient sampling method was used in conducting the study. Standard closed ended questionnaire was used to elicit responses from registered nurses at the Enchi Government Hospital. The study revealed that out of the total 150 respondents, 75.1% (112) of the total respondents’ responses depicted good perception on pain management, 76.7% (115) showed good knowledge on pain management and 51.4% (77) revealed good attitude towards pain management. In conclusion, majority of nurses at Enchi Government Hospital have good perception, good knowledge and good attitude towards pain management with others being at deficit. It is recommended that more studies are conducted on this subject concerning the topic of this study, other pertinent topics on pain management, in-service training conducted periodically and also implemented in curriculum for nursing education in Ghana.