Evaluation of used eye drop containers for microbial contamination in outpatient department of tertiary care teaching hospital

Background: Contaminated eyedrops are considered as serious risk factor for many iatrogenic ocular infections. Apart from the risk of infection, microbial contamination may alter the pH of the solution thereby reducing the efficacy of drugs. Presently many preservatives are added to these eye drops preparations to extend the duration of use. Hence authors aimed this study to find the contamination rates in such eye drop preparations.Methods: This was a prospective observational research conducted at Ophthalmology OPD, of tertiary care teaching hospital for the period of 2 months. Total fifty five used eyedrops were collected.Results: Authors found that 25.45% of the collected eye drops were contaminated with various organisms, viz. E. coli (10.90%), Staphylococcus aureus (9.09%), Pseudomonas aerugenosa (1.81%), Bacillus subtilis (1.81%) and Candida albicans (1.81%). Among various eyedrops, mydriatic (60%) eyedrops had the highest rate of contamination. We also found that, different preservatives in the eye drops were presents with different level of microbial contamination.Conclusions: The present study showed that there is a definite co-occurrence between eyedrop contamination and ocular infections irrespective of preservatives. This research raises a concern about questionable efficacy of preservatives.

Add on dexmedetomidine in the treatment of severe alcohol withdrawal in a patient of emergency laparotomy.

According to American statistics 90% of people drink alcohol at some time in life. The estimated prevalence of alcohol abuse among hospitalized in patients is 20 % and 10- 33 % in patients admitted to the ICU. Approximately 18% of these patients will develop alcohol withdrawal syndrome (AWS) whose symptoms can include physical and psychological manifestations that range from mild to life threatening. Although AWS has been reported in literature in post-operative periods and in intensive care unit, there is less information on treatment and preparing of a patient with AWS, coming for emergency surgical procedure. The surgical stress and deranged liver functions possess an additional challenge to the anesthesiologist. Here we are reporting the successful management of a case of delirium tremens by using Dexmedetomidine in pre, intra and post-operative period in a patient with hollow viscous perforation for emergency laparotomy.

Comparison between score recording in traditional method and indigenous technique during evaluation in viva voce.

Background: Viva voce which is integral part of practical examination plays important role in evaluation during practical examination in pharmacology. Existing traditional method has disadvantages of subjectivity, less accuracy, no documentary record of performance and is exhaustive for examiners. Methods: In this study we compared a newly designed code conversion technique with traditional method of viva voce evaluation on second MBBS Pharmacology students. Those appearing for pre-university examination in the department were observed for both the methods of evaluation. Results: It is observed that there were cases of overvaluation and undervaluation indicating subjectivity in traditional method evaluation while documentary recording and accuracy possible in code conversion technique. Conclusion: Thus code conversion technique has potential to replace traditional method evaluation as it minimizes all disadvantages of traditional method to make fair and more accurate assessment of students during viva voce part of practical examination. The only drawback of prolonged result complication time can well be adjusted at the university end.

Questionnaire based assessment of teaching effectiveness during a lecture series on pharmacotherapeutics.

Background: Lecture is a widely accepted method of teaching & learning. It provides more of surface learning and covers larger text in specified time. However it has a disadvantage that there is no assessment about the extent of knowledge learner receives. Hence, we designed a daily questionnaire based evaluation technique. Methods: Without disclosing the topic, second year MBBS students (mean n=23) after learning from lecture series in Pharmacology, participated voluntarily to a questionnaire based task on eight therapeutic lecture topics. They wrote answers separately in 5-10 minutes before, and after delivery of text without referring to notes i. e. pre-test & post-test. Papers were valued on score basis, data recorded, interpreted and analyzed. Results: Mean acceptability (81.4%), mean improvement (94%), mean collective maximum score (96%), mean individual maximum score (92%) were observed. 85-100% participants out of total 184 in eight therapeutic lecture topics passed in post-test (None passing in Pre-test) reflected good improvement in cognitive structure. Conclusion: Performance in such tests provides feedback on teaching effectiveness, specificity & adequacy of knowledge gained by learners.