Introduction: Neonates are most vulnerable to infections due to poor immune system leading to high morbidity and mortality, which justifies early diagnosis and prompt treatment with antibiotics. Antibiotics are the most frequently used drugs in Neonatal Intensive care units. Aim and Objective: The objective of present study was to identify the pattern of use of antimicrobial agents in neonates at the neonatal intensive care unit (NICU) of NGMC. Materials and Methods: A hospital-based, retrospective study (prescription audit) was conducted over a period of 5-month duration at Nepalgunj Medical College by reviewing case records of NICU. Data were collected and analyzed. Results: A total of 150 case records were reviewed and were included in the study. Out of the 150, Neonates 86 (57.33%) were male babies and 64 (42.67%) were female babies. Maximum number (72.66%) neonates admitted to NICU were of low birth weight and most common reason for NICU admission was neonatal septicaemia. The majority of neonates (68.67%) received 2 antimicrobial agents (AMAs), 21.33% received 3 AMAs and average number of antibiotic per case was 2.44. The most commonly prescribed antimicrobial agent was Cefotaxime (58.66%), followed by Amikacin (48%), Ceftriaxone (32%). In fixed dose combination Piperacillin + Tazobactum (28%) was most commonly prescribed. All of the antimicrobial agents were prescribed by brand name. Conclusion: Measures need to be undertaken to encourage physicians to prescribe AMAs in generic names to minimize health care cost. Present study suggests that Antibiotics policy to be framed & periodically reviewed: to reduce unnecessary use of antibiotics and associated problems.

Introduction: Oral Submucous Fibrosis (OSMF) is a precancerous condition of the oral mucosa. It is characterized by excessive production of collagen leading to inelasticity of the oral mucosa and atrophic changes of the epithelium.Aim and objective: To evaluate the efficacy of oral Colchicine in comparison to intralesional injections of Dexamethasone plus Hyaluronidase in the management of OSMF patients.Materials and Methods: Fourty patients with OSMF were randomly divided equally into two groups. 20 patients in Dexamethasone group received biweekly intralesional injections of Dexamethasone (4mg/ml) plus Hyaluronidase 1500 IU in buccal mucosa for a period of 12 weeks. Other 20 patients in Colchicine group received oral Colchicine 0.5 mg tablets twice daily for 12 weeks. Parameters taken in the study were burning sensation, and mouth opening. Descriptive statistics, paired t test and unpaired t test were used for statistical analysis.Results and Conclusions: The pre- and post-treatment differences were found to be statistically significant for both the groups (p<0.001) and for both the treatment outcomes. When the average difference of the treatment outcomes was compared between the two study groups, statistically highly significant difference was noted (p <0.001) only in mouth opening but not in burning sensation.These encouraging results should prompt further clinical trials with Colchicine on a larger sample size to broaden the therapeutic usefulness of the drug in the management of OSMF. JNGMC,  Vol. 14 No. 2 December 2016, Page: 60-65

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Background: Hypertension is the leading cause of morbidity and mortality worldwide which requires long term therapy to prevent complication associated with it. As drugs are used for longer duration it is necessary to know potential undesirable effects for making the appropriate choice. Aim and objective of the study was to monitor the adverse drug reactions (ADRs) and to know prescribing pattern of antihypertensive monotherapy.Methods: The present work was an open, non-comparative, observational study conducted on seventy-three (73) hypertensive patients who were prescribed single antihypertensive drug at medical OPD of Nepalgunj Medical college by conducting patient interviews, recording the data on ADR monitoring form.Results: Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n=12), followed by diuretics (n= 6), Angiotensin converting enzyme inhibitors (n=3), β-blockers (n= 2) and Angiotensin receptor blocker (n=1). Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 10). On analysis of prescription pattern again amlodipine was most commonly prescribed antihypertensive monotherapy followed by hydrochlorothiazide.Conclusions:Amlodipine was most commonly associated with ADRs and it was also most commonly prescribed antihypertensive drugs as monotherapy. The above findings would be useful for physicians in rational prescribing.

Introduction: Maternal mortality is an indicator of the quality of obstetric care in a community directly reflecting the utilization of health care services available. Maternal mortality has been recognised as a public health problem in the developing countries. Aim and Objective: To analyse the etiology of maternal deaths. Material and Methods: This descriptive study was conducted in the gynaecology and obstetrics department of the Nepalgunj Medical College Teaching Hospital Banke Nepal for a period of two years from august 2016-august 2018. All cases of maternal deaths in line with the definition of World Health Organization have been included. Data were collected and analyzed. Results: Twenty three (23) maternal deaths were identified during the study period. 69.56% of deaths occurred due to direct obstetric causes. Uncontrollable postpartum haemorrhage with 37.5 % was the leading cause of maternal death followed by eclampsia (18.75%) and sepsis (18.75%). Indirect causes were dominated by heart disease. Maximum 56.5% of deaths had occurred after 48 hours of admission. Conclusions: Haemorrhage, eclampsia and infections are the main causes of maternal deaths in our study. access to emergency medication, transfusion and anaesthetic and surgical teams in hospitals but also through the involvement of religious leaders, traditional and any community to better understand the population obstacles to reducing maternal mortality.