Objective: The current study aims to evaluate prescribing pattern and potentially inappropriate medicine (PIM) among elderly patients in a tertiary care hospital of western Nepal. Methods: A prospective cross-sectional study was conducted in the outpatient department of Manipal Teaching Hospital of Western Nepal. The World Health Organization prescribing indicators and Beers’ 2015 updated criteria were assessed to analyze the result. Results: The mean±standard deviation of the age was 73.47±6.42 years and the majority of patients were in the age group 65–74 (58.81%). Male preponderance (male: female=1.20:1) was found. The value of prescribing indicator includes the average number of drug per prescription (4.91), percentage of generic name prescription (3.40%), percentage of antimicrobials prescribed (19.40%), percentage of injections prescribed (2.70%), and percentage of the drug from essential drug list of Nepal (42.22%). At least one PIM was prescribed to 87 (21.6%) patients. Non-cyclooxygenase-selective nonsteroidal anti-inflammatory drugs (44%) and anticholinergics (18%) were the most frequently prescribed PIMs. Conclusions: Polypharmacy, PIMs, and potential drug-drug interaction were prevalent in this study. It is recommended that all the doctors, pharmacists, other concerned health-care professionals, patients, policymakers, and all other stakeholders must be aware of these situations and a multidisciplinary approach must be developed for the promotion of rational use of drugs.

Introduction: Numerous locally accessible plants in Nepal are left unseen. So, exploring their antioxidant activity for medicinal purposes can be beneficial in treating various diseases. Antioxidants have great importance in terms of reducing oxidative stress that causes damage to biological molecules. The qualitative analysis of chemical constituents using a chromatographic technique like TLC plays a pivotal role in this aspect. The present study aimed at performing chemical profiling using thin-layer chromatographic technique and evaluation of the antioxidant activity of selected medicinal plants. Methods: Firstly, TLC profiling of 70% methanolic extracts of eighteen medicinal plants was done using preparative TLC plate in two different ratio of chloroform, methanol and water. Then, antioxidant activity was tested by DPPH (2, 2-diphenyl-1-picrylhydrazyl) free radical scavenging assay by using a 96 well plate method at wavelength 510 nm in which Trolox was taken as standard. Results: Flavonoids, tannins, saccharides, and phenols were identified from TLC profiling. The yield value of Sapium insigne leaves extracts i.e. 20.52% was highest and Monochoria vaginalis leaves possess the least i.e. 3.93%. Solena heterophylla leaves extract with IC50 amount i.e. 21 µg/ml was found most potent among all the plant extracts. Conclusion: The results imply that the extract of ethnomedicinal plants is rich with a variety of phytochemicals, which can be used as natural antioxidants. However, further studies are warranted to isolate and identify the chemical and biological properties of obtained extracts for the provision of scientific evidence for traditional uses.

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Objective: The current study aims to determine the pattern of drug usage in terms of patient-care, facility care, and complementary drug use indicators among elderly people. Methods: The study was a prospective cross-sectional study that was conducted in the outpatient department. Patient-care, facility care, and complementary drug use indicators were assed as per the WHO/INRUD indicators. Patient/patient party knowledge of correct dose was analyzed by the information; time of administration (when) and quantity of drugs to be taken (how much). Results: The duration of consultation in the ophthalmology department was comparatively longer (30.33 min) than in other departments. The dispensing time of the medicine department was 126.60 s which was higher than other departments. Among the total medicines, 88.58% were dispensed, 21 (1.06%) of the total drugs had the patient’s name labeled on the envelope while 1430 (81.53%) of the drugs had drug name and 1617 (92.19%) only had the administration time labeled on the envelope. On interviewing patients/patient parties, 240 (59.55%) knew both the time of administration and the number of drugs to be taken. The average medicine cost encountered per patient was found to be Nepalese rupees (NRs.) 1353±1079 NRs. (US$ 11.57±9.23). Conclusion: It is concluded that systematic changes need to be applied to improve the patient knowledge, to deliver quality advice to the patients, and to maintain the process of adequate labeling in medications.

<p class="abstract"><strong>Background:</strong> Urinary tract infection (UTI) is the most common infection caused by the presence and growth of pathogenic microorganisms within the human urinary system into the lower and upper genito-urinary tract. UTI continues to be major health problems in developing countries like Nepal.</p><p class="abstract"><strong>Methods:</strong> A prospective observational study was conducted from June 2019 to November 2019 in the outpatient and inpatient department of Manipal teaching hospital. The face-to-face interview was adopted in 137 UTI patients with the census sampling technique.  </p><p class="abstract"><strong>Results:</strong> A total of 137 patients (121 out-patients and 16 in-patients), 82 (59.85%) female, and 55 (40.15%) males were enrolled in which UTI was observed in more than half of the sample in the aged group of 25-54. <em>Escherichia coli</em> was the most common uropathogens isolated whereas dysuria was the most common presenting symptom among the patients. Cefixime 200 mg followed by nitrofurantoin 100 mg was the most commonly prescribed medicine for UTI. Disodium hydrogen 1.40 g oral liquid, pantoprazole 40 mg tablet, and multivitamins were commonly prescribed supportive medications. The empirically prescribed average cost was Nepalese rupee (NRs.) 820.44 whereas the total definitive average cost was NRs. 305.54. The average cost of medical management for in-patients was NRs. 2316.55 including registration, urine analysis, investigation bed charge, and other consumable charges as well as discharge medicine cost.</p><p class="abstract"><strong>Conclusions:</strong> With lower cost, higher sensitivity, and high prescription, cefixime, and nitrofurantoin could be better drugs for the management of UTI among outpatient department (OPD) patients while ceftriaxone could be better for in-patients.</p><p> </p>