Management

Nursing is a highly demanding and stressful profession that requires the ability to cope with critically ill or dying clients and medical emergencies. Nurses often encounter tough situations that demand dedication, sound academic knowledge, clinical skills, and time management to complete multiple tasks effectively. Coping strategies and resilience are essential to maintain well-being and ensure quality patient care. The objectives of present works are To assess pre-existing knowledge regarding stress management among ICU nursing officers in a selected hospital at Hassan. To evaluate the effectiveness of a self-instructional module (SIM) on stress management. To determine the association between pre-test knowledge scores and demographic variables. An interventional one-group pre-test post-test pre-experimental design was adopted. Forty participants were selected using purposive sampling. Data was collected through a structured knowledge questionnaire. The SIM was administered after the pre-test, and the post-test was conducted after 7 days. Data was analyzed using descriptive and inferential statistics. The mean post-test knowledge score (72.18%) was significantly higher than the pre-test score (36%) (Paired t = 21.915, df = 39, p < 0.001). Pre-test knowledge levels were significantly associated with number of children. The study concluded that the self-instructional module was effective in improving knowledge regarding stress and its management among ICU nursing officers.

The aim of the study was to analyze the incidence of adverse drug reactions (ADRs) at a tertiary care hospital and assess the functioning of the reporting system. The outcome of the study would provide information regarding associated factors and pharmacoeconomic impact of the ADRs. The causality assessment was determined by WHO UMC probability scale and Naranjo’s algorithm. Outcomes of ADR, management and the pharmacoeconomic impact was assessed. Overall incidence of ADRs among the patients was 4.5%. A total of 61 ADRs were detected from 54 patients. As per the WHO UMC scale 44.3% of the ADRs were possible and as per the Naranjo’s scale 53.1% of the ADRs were possible. Majority of the reactions were moderate in severity (47.6%). Most of the ADRs (73.8%) were predictable reactions and 39.3% were probably preventable. Multiple drug therapy (27.77%) was the most common associated factor. Withdrawal of the offending drug was the main line of management.  Symptomatic treatment was required in majority of cases. The total direct cost involved in treatment of ADRs was INR 1, 10,284 (US$ 1730.22) at a rate of INR 2042.29 US$ 32.08 per patient. The direct cost per patient involved in ADR related hospital admissions (INR 2689 i.e US$ 42.30) was higher than ADR during hospitalization (INR 1769.60 i.e US $ 27.83).The ADRs were not recognized and recorded in majority of the cases. Patients on multiple drug therapy are more vulnerable to ADRs. The incidence and alarming pharmacoeconomic impact of the ADRs suggest that there is a need for a continuous monitoring system at tertiary care hospitals.

Gestational diabetes mellitus (GDM) is defined as glucose intolerance of various degrees that is first detected during pregnancy.  Insulin deficiency in turn leads to chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism. As with diabetes mellitus in pregnancy in general, babies born to mothers with gestational diabetes are typically at increased risk of problems such as being large for gestational age (which may lead to delivery complications), low blood sugar, and jaundice. There are 2 subtypes of gestational diabetes. One is Type A1 gestational diabetes where abnormal oral glucose tolerance test (OGTT) but normal blood glucose levels during fasting and 2 hours after meals; diet modification is sufficient to control glucose levels) and other is Type A2 gestational diabetes where abnormal OGTT compounded by abnormal glucose levels during fasting and/or after meals; additional therapy with insulin or other medications is required. The goal of treatment is to reduce the risks of GDM for mother and child. A repeat OGTT should be carried out 2–4 months after delivery, to confirm the diabetes has disappeared. Afterwards, regular screening for type 2 diabetes is advised. If a diabetic diet or G.I. Diet, exercise, and oral medication are inadequate to control glucose levels, insulin therapy may become necessary. Glyburide and Metformin, a second generation sulfonylurea, has been shown to be an effective alternative to insulin therapy. In one study, 4% of women needed supplemental insulin to reach blood sugar targets. Key words: Gestational diabetes mellitus, etiology, Management, oral hypoglycemic agents.