Biomedical subjects

V Diwan

Publications and source records attributed to V Diwan.

22 records · Page 2Linked to original sources

PubMed1990

Paediatric prescribing in out-patient care. An example from Sri Lanka.

Few drug utilization studies have been focused on children in developing countries, where they constitute a large part of the total population. The present study describes prescribing in 5 outpatient departments (15 practitioners) in an area of Sri Lanka over a period of seven months. It includes a random sample of 2484 paediatric consultations. On average, 2.7 drugs were prescribed per patient. With a few exceptions generic prescribing of oral drugs prevailed, and only 1% of the children were given injections. In all, 107 different products were used. Antipyretics, antihistamines, antibiotics and sulphonamides were the most commonly used classes of drugs, being prescribed for 40-50% of the children. Penicillin V represented 43% of the total antibiotic prescribing. Only 1.2% of the children and 0.5% of the infants were given tetracycline. Paracetamol was the preferred antipyretic drug in infants. The use of injectables and tetracycline in children has been reported to be common in other developing countries. The practitioners in Sri Lanka showed a more rational prescribing pattern with the exception of the frequent use of antihistamines, cough medicine and an antiflatulent. The need to develop a paediatric drug policy is discussed.

Age Factors↗

PubMed1986

Fatal radiation hepatitis: a case report and review of the literature.

A case of fatal radiation hepatitis occurring after treatment with 2200 rad given by the moving strip technique is presented. This fatality occurred in a 28-year-old woman with persistent ovarian carcinoma despite prolonged chemotherapy. Scans of the liver using computerized tomography, 99mTc sulfur colloid, and 99mTc diisopropyl iminodiacetic acid showed abnormalities only in sulfur colloid uptake and these resolved late in the course. Death was caused by progressive hepatic and renal failure. Postmortem examination showed changes typical of radiation hepatitis. Only 32 cases of radiation hepatitis have been previously reported and they are reviewed. The possible role of prolonged prior chemotherapy in enhancing sensitivity to radiotherapy is considered.

Adult↗

PubMedDate not supplied

A description of outpatient drug use in rural China: evidence of differences due to insurance coverage.

This paper describes the effects of health financing systems (insurance) on outpatient drug use in rural China. 1320 outpatients were interviewed (exit interview) in the randomly selected county, township and village health care facilities in five counties in three provinces of central China. The interview was face to face. Questions were asked by a trained interviewer and were answered by patient him/herself. The main finding was that health insurance appeared to influence drug use in outpatient services. The average number of drugs per visit was 2.56 and drug expenditures per visit was 16.9 yuan. Between insured and uninsured (out-of-pocket) groups, there were significant differences in the number of drugs and drug expenditures per visit. The insured had a lower number of drugs and a higher drug expenditure per visit than the uninsured, implying the use of more expensive drugs per visit than the uninsured. There were also significant differences in the number of drugs and drug expenditures per visit between the types of insurance. One third of the drugs were anti-infectives, most of which were penicillin, gentamycin, and sulfonamides. The results imply that uninsured patients do not receive the same care as the insured do even if they have the same needs. The fee-for-service financing for hospitals and health insurance have changed health providers' and consumers' behaviour and resulted in the increase of medical expenditure.

China↗

PubMedDate not supplied

Views on involving a social support person during labor in Zambian maternities.

Because social support persons are excluded from modern obstetric care in Zambia, the aim of this study was to explore the views of 84 mothers and 40 health staff about allowing women to be attended by a supportive companion during labor in Zambian urban and rural maternities. Most of the mothers wanted a companion present to provide emotional and practical support. Those who were opposed to the idea had nobody to ask to be with them, or they had relatives who would interfere with the care provided. All health staff cited hospital policy as the principal reason for prohibiting social support persons from staying with laboring women. They also said that the health staff's role is to care for laboring women, and they worried that social support persons could interfere with their work by giving the laboring women traditional medicine. However, most health staff also said that a social support person could help the laboring women and give her a sense of security. The study concludes that Zambian maternity staff should be exposed to new research findings about the benefits of social support during childbirth and that this practice should be encouraged in Zambia. Ultimately, it should be the laboring woman who decides whether she wants to bring a social support person to the labor ward.

Adolescent↗