Physiology

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Browsing Physiology by Author "Massele, Amos Y."

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    Assessment of prescribing practices at the primary healthcare facilities in Botswana with an emphasis on antibiotics: Findings and implications
    (International journal of clinical practice, 2017-11-27) Mashalla, Yohana J.; ; Massele, Amos Y.
    Background and Aims Inappropriate drug prescribing has increased especially in developing countries where systems for monitoring medicine use are not well developed. This increases the rate of antimicrobial resistance. The study aim was to assess the prescribing patterns among urban primary health facilities in Botswana to provide future guidance including developing future quality indicators. Methods Retrospective data from patients’ records between January and December 2013 in 19 clinics were collected in a cross-sectional study. The WHO/International Network for Rational Use of Drugs indicators were used to assess prescribing patterns in the study clinics. Results Average number of drugs per prescription was 2.8; 78.6% of the prescribed antibiotics were by International Non-proprietary Name and 96.1% complied with the Botswana Essential Drugs List. Overall rate of antibiotic prescribing was high (42.7%) with 14.7%, 5.9% and 1.3% of prescriptions having two, three and four antibiotics, respectively. Systemic antibiotics (JO1C) accounted for 45.4% of prescribed antibiotics of which amoxicillin accounted for 28.4% and metronidazole 14.4% of all antibiotic prescriptions. There was low use of co-amoxiclav (0.3% of all antibiotic prescriptions). Third generation cephalosporins and macrolides accounted for 9.8% and 6.2% of antibiotic prescriptions respectively, with no prescribing of fluoroquinolones. The majority of indications (87%) for antibiotic prescriptions were according to ICD classification. Conclusions While most indications for antibiotic prescriptions were based on signs and symptoms according to ICD, antibiotic prescribing rates were high with some conditions not requiring antibiotics because they are viral infections. There is a need to further improve prescribing practices through induction and training of in-service prescribers. An effective management tool for monitoring antibiotic prescribing practices at Primary Health Care facilities should be designed and implemented, including developing robust quality indicators.
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    Pulmonary function parameters in asthma patients receiving oral ketotifen.
    (1990-12-01) Mashalla, Yohana J.; Massele, Amos Y.
    Ketotifen, an antianaphylactic and antihistamine drug was given orally to 31 asthma patients who had significant airflow limitation (mean FEV1% FVC = 65.1). 19 patients had extrinsic asthma and 12 patients had intrinsic asthma. Ketotifen was given in a dose of 1 mg twice daily for 16 weeks. At the end of this period, concomitant medication, frequency and severity of asthma attacks and mean lung function test results were analysed. The number of acute asthmatic attacks were reduced significantly from a mean of 7.1 attacks/week before treatment to 0.28 attacks/week after 16 weeks of treatment (P less than 0.001). The severity of attacks and the need to use concomitant bronchodilators agents were also reduced. Lung function improved following oral ketotifen administration as indicated by changes in FVC, FEV1, FEV1% FVC and PEF. FVC increased insignificantly (18.64 ml/week, P less than 0.3), while FEV1, FEV1% FVC and PEF improved significantly (33.45 ml/week, 0.76%/week and 5.52 l/min/week respectively, P less than 0.01). It was concluded that the relief which is often observed in patients suffering from bronchial asthma on ketotifen therapy is associated with an improvement in the lung function. Hence, ketotifen is effective in the prophylaxis of both extrinsic and intrinsic asthma.
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    Respiratory physiology training in Tanzania: Need to focus on primary respiratory care.
    (Journal of Physiology and Pathophysiology, 2011-05) Mashalla, Yohana J.; Massele, Amos Y.
    Effective management of Chronic obstructive pulmonary disease (COPD) by General Practitioners is likely to be compromised by respiratory physiology training that has main focus on acute respiratory diseases with high mortality and little focus on empowering medical and nursing students and practitioners on respiratory care. Results of this study indicate that lack of responsiveness of respiratory physiology courses for undergraduate and postgraduate and lack of structured in-service training programmes on respiratory care and inadequate training facilities for lung function assessment are key challenges to the medical schools. It is concluded that concerted effort is required through global partnership to enhance training and re-training of general practitioners and nurses on primary respiratory care and making accessible relevant resources needed for building competencies in lung function assessment and interpretation of results.