Background: Assessment of knowledge, attitudes and practices (KAP) of antibiotic prescription among doctors may help in developing guidelines to improve antibiotics use and decrease resistance. Aims and objectives: Our aim was to evaluate KAP regarding antibiotic use and its resistance among doctors. Materials and Methods: A cross sectional, questionnaire based study was conducted among the doctors of B.P. Koirala Institute of Health Sciences, Dharan, Nepal between January-March 2016 and their KAP regarding antibiotic use and resistance was assessed by using a five point Likert scale. The data were analyzed by calculating percentage and frequency. Results: Almost half of the doctors (50.2%) used to prescribe antibiotics more than once daily. Nearly two thirds of the doctors (65.3%) received antibiotic education at a formal lecture on ward rounds. Most of the doctors (87.4%) agreed that antimicrobials are overused. One hundred thirty four doctors (42.3%) agreed that patients' demands for antibiotics contribute to its overuse. Nearly two third doctors (70.7%) believed that locally developed antimicrobial guidelines would be more useful. Most of the respondents (89.9%) wanted more ongoing education on antibiotic use and its resistance. Conclusions: Our study reveals that antibiotics are overused and patients' demand contributes to this. Locally developed antimicrobial guidelines would be more useful. More CME on antibiotic use and its resistance should be conducted to enhance the awareness among doctors.

Background: The burden of substance abuse amongst the youths has increased worldwide including Nepal. There is limited data on prevalence of substance abuse among the adolescents. Hence this study aims to determine the prevalence of substance abuse amongst the adolescents of Dharan, Eastern Nepal.Methods: A cross-sectional study was conducted from July 2018 to December 2018. Self-administered structured questionnaire adapted from National Youth Survey sponsored by the Centre for Substance Abuse Prevention was used for data collection from 1125 higher secondary school students. Data was cleaned in Microsoft Excel and analysed using SPSS version 11.5.Results: Prevalence of ever users of tobacco were 46.04% of which the current users were 20.46%, ever users of alcohol were 37.58% of which 15.20% were current users and ever users of drug was 18.19% of which 18.13% were current users. The average age of initiating tobacco, alcohol and drugs were 14.21 ± 3.51, 15.13 ± 7.43 and 14.32 ± 4.41 years respectively. More than half of the drug users (50.71%) used cannabis and the most common reason for using any substance was peer pressure (91.64%). More than one-third (39.5%) purchased any of these substance from local shops. Conclusions: The study reported significant proportion of adolescents involved in substance abuse. The findings of this study may be beneficial for revising/ updating action plans on prevention and control of substance abuse in Nepal.Keywords: Adolescents; alcohol; drug; substance abuse; tobacco.

Our study aimed to assess and compare the bioavailability of Eptoin 100 mg and Epileptin 100mg tablets in Nepalese healthy volunteers. A randomized, two-treatment cross-over study with two weeks’ wash-out period was conducted in 12 healthy non-smoker and non-alcoholic Nepalese male volunteers over a period of 6 months in the department of Clinical Pharmacology and Therapeutic at B. P. Koirala Institute of Health Sciences, Dharan, Nepal after approval from the Institutional Review Committee. The participants were randomized using sealed envelope system and received a single 100 mg oral tablet of either of the formulations with a two week washout period. Blood samples were collected predose and at regular intervals postdose upto 72 hours. Plasma phenytoin levels were estimated by reverse phase high performance liquid chromatography. The analytical method was validated prior to the start of study. Cmax (Peak Plasma Concentration), Tmax (Time to achieve maximum Plasma Concentration), AUC0-72 (Area under plasma concentration time curve 0 to 72 hours), AUC0-∞ (Area under plasma concentration time curve 0 to ∞) and T½ (Elimination half-life) and Kel (Elimination rate constant) were calculated and 80-120% margin (90% confidence interval) was used to assess bioequivalence. ANOVA test was used to analyze the data at P-value of 0.05. All volunteers completed the study. The log-transformed values of Cmax, Tmax, AUC0-t, and AUC0-∞ of the both formulations were within the specified limits and were bioequivalent according to the regulatory definition of bioequivalence based on the rate and extent of absorption. Both products can be considered equally effective in medical practice. Keywords: Bioavailability, Bioequivalence, healthy volunteer, Nepal, phenytoin sodium.

Background: In Nepal, basic health care services at the grass root level are delivered by Sub-

Background: Prescription is a written instruction by a health care personnel to pharmacist to dispense drug(s). Irrational drug prescribing is a global problem, particularly in developing and transitional countries. This study was conducted to see the status of World Health Organization (WHO) core prescription indicators, complementary indices and prescription errors. Methods: It was a quantitative cross-sectional descriptive study carried out among inpatients of general surgery of tertiary hospital in eastern Nepal. Ethical approval for the study was obtained from the Institutional Review Committee. It was a convenience sampling. Calculated Sample size was 224. Enrollment of patients started on 16 May 2018 with the last case being enrolled on 1 Oct 2019 after obtaining informed consent. Relevant data was entered in a semi-structured proforma. Microsoft excel 2016 and IBM Statistical Package for the Social Sciences (SPSS) v. 21 were used for descriptive statistics. Results: Median age of inpatients was 40 (24 - 54) years with male: female ratio being 1.05. Total 1492 drugs were prescribed in 224 prescriptions. Mean number of drugs prescribed was 6.66 ± 2.33. Percentage of drugs prescribed by generic name was 25.60%. Prescriptions with at least one antimicrobial agent was 89.3%. Prescriptions with at least one injection was 92.9%. Percentage of drugs prescribed from the WHO Essential Medicine List was 66.48%. Other complementary prescribing indicators and prescription errors were also calculated. Conclusions: Most prescription indicators were inadvertently deviated away from WHO standards. Prescription errors were comparable to other studies.