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Volumen 6, Asunto 4 (2014)

Artículo de investigación

A Retrospective Analysis of Prescribing Practices through WHO Prescribing Indicators at Four Selected Hospitals of West Ethiopia

Jimma Likisa Lenjisa and Tadese Haile Fereja

Background: Periodic assessment of the prescribing practices in a health facility is necessary to identify specific drug use problems, sensitize practitioners on rational drug prescription and provide policy makers with relevant information. The purpose of this survey is, therefore, to analysis the prescribing practice of clinicians using world health organization (WHO) prescribing indicators at four selected public hospitals found in west Ethiopia with ultimate goal of ensuring rational drug use.

Methods: This study was a descriptive cross-sectional survey which investigated the prescribing practices of prescribers using WHO core prescribing indicators at four selected hospitals in west Ethiopia. We have retrospectively reviewed 2024 prescriptions found in outpatient pharmacies of each hospital selected through systematic random sampling over one year period from July to September 2013.

Results: In this work, the mean number of drugs per prescription was 2.1 ± 0.5. Generic, antibiotics and injection prescribing were found to be 79.2%, 54.7% and 28.3% respectively. Less than half (45.3%) of these sampled prescriptions had diagnosis for which drugs are indicated. Whereas drugs prescribed from essential drug list/ formulary of the country constituted 83.0% which is far less than the ideal limit.

Conclusion: The findings in this study are similar to what had been reported by most of the previous studies. Generally, all the prescribing indicators studied are out of the ranges recommended by WHO implying that there is deep rooted irrational prescribing practice in hospitals of Ethiopia. Therefore, urgent and well organized interventions should be implemented by federal ministry of health and drug regulatory bodies found at different levels in order to foster rational drug use in the country.

Artículo de investigación

How to Recovery of Damaged Microorganisms by Supplying Several Sorts of Nutrients

Hideharu Shintani

Final sterilization was conducted to health care products immediately prior to shipping and sterility assurance OF 10-6 of SAL (sterility assurance level) must be confirmed from the result of Biological indicators (BIs). The survived microorganisms after sterilization may be mostly damaged and injured microorganisms. The auxotrophic characteristics of injured microorganisms are different from those of healthy microorganisms. In that sense, the cultivation conditions and culture medium constituent of injured microorganisms must be used for confirming reproducible sterilization validation study, otherwise it may result in false negative at shipping test. This is indispensable to attain safety assurance of health care products. The evaluation of several sorts of nutrients must be studied to recover injured microorganisms and support growth reproducibly. It is also important to study for diminishing variation of culture medium performance among culture medium suppliers and that lot to lot or batch to batch variation to attain reproducible sterility assurance. These were studied by adding several sorts of agents to the culture medium inoculating injured microorganisms exposed by moist heating, dry heating, ethylene oxide gas exposure gamma-ray and electron beam irradiation. Even though sterilizing method may differ, when amino acids mixture, gucose and calcium were added to the culture medium, cultivation performance of injured spores was significantly improved and reproducible sterilization validation can be attained in success.

Artículo de investigación

Comparative Histopathological Diagnosis of Cutaneous Melanoma by H&E, Special Staining and Immunohistochemical Methods against Cutaneous Squamous Cell Carcinoma in Horse and Bovine

Javad Javanbakht, Farhang Sasani, Farajollaheh Adibhashemi and Soheila Hemmati

Background: The aim of this study was to compare the role of special staining and to test melanoma associated antigens against paraffin embedded bovine and equine melanomas in order to assess their ability and utility as diagnostic tools for diagnosis and confirmation of the melanomas.

Methods: From 1991-2012, 13 cases were reviewed histologically, and each case was found to contain a large focus of melanoma and squamous cell carcinoma (SCC) on the hematoxylin and eosin–stained tissue section. All cases had documented cutaneous melanoma and SCC. Serial 5 μm-thick sections were cut from routine formalinfixed paraffin blocks of 4 case cutaneous SCC (including 2 cases from horses and 2 cases from cattle) and 9 case cutaneous melanomas (including 6 horses cases and 3 cattle cases) from the files of the Department of Pathology have been diagnosed by H&E staining method. For diagnosis confirmation, Fontana-masson silver method, melanin bleaching method and immunohistochemical staining for S-100 protein and HMB45 antigen were applied. Majority of cases encompassed intradermal histologic pattern.

Results: In 6 cases out of 9 tumors, both S-100 protein and HMB45 staining methods were positive, whereas there were suspicious results for 3 cases. In all cases, results of Fontana-masson silver and melanin bleaching methods were positive. In 4 cases of squamous cell carcinoma, results of 3 tests were negative. Diagnosis of suspicious melanoma tumor cases must be confirmed or reconfirmed by special staining methods and/or immunohistochemical method.

Conclusions: The standard of practice in diagnosing melanoma is to use a panel of antibodies consisting primarily of S-100 protein and HMB-45. For spindle cell and desmoplastic melanomas, however, S-100 protein and HMB-45 should remain within antibody panel since S-100 protein is most sensitive marker for these entities and evidence is lacking that either Melan-A or Mitf are better markers than HMB-45 for recognizing spindle cell melanocytic lesions.

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