.Vercirnon cancer Statistical AnalysisDistribution (frequency, proportion with corresponding standard errors) of the physicians’ characteristics, diarrhea-related knowledge and rationality of management were determined. Logistic regressions were conducted to measure the strength and direction of associations [Odds Ratios (OR), corresponding 95 confidence intervals (95 CI) and p values] between physicians’ characteristics/knowledge and rationality of diarrheal management. SAS version 9.2 was used for statistical analyses.ResultsSocio-demographic distribution and diarrhea-related knowledge (domain-wise and overall) of the 264 participating practitioners were presented elsewhere [23]. Briefly: most of them (92.05 ) were male, 53.03 had no recognized medical qualifications, 25.76 were medical graduates involved in general practice and 21.21 were specialists with postgraduate qualifications. Majority (72.35 ) were practicing for more than 10 years, 18.56 were not attached to any healthcare institution, while only 6.06 were working in Governmental hospitals. Different practitioners preferred different IVF for managing severely dehydrated diarrhea cases while only 17.80 and 18.18 respectively used ringer lactate or normal saline principally. Among the participants, 32.95 advised laboratory test of stool to identify the causative organism of diarrhea after initiating antimicrobial therapy and only 26.14 mentioned that for diagnosing the causative organism of diarrhea they advised stool/rectal swab culture. Proportions of participants having best knowledge about diarrheal disease (signs/symptoms), its occurrence/spread, management, prevention/control, cholera, and ORS were as low as: 15.53 , 25.76 , 16.29 , 44.70 , 7.58 and 14.39 respectively while only 19.32 practitioners had best overall knowledge regarding diarrhea. Only 20.08 were rational regarding overall laboratory testing strategy (advice and timing together). While treating cases of acute watery/bloody diarrhea, only 17.05 prescribed antibiotics rationally, for mucoid diarrhea this proportion was 24.62 and overall involving all types of diarrhea it was only 7.20 . Rational use of IVF was observed among 17.80 , 26.14 rationally advised laboratory investigations for diarrhea cases while rational laboratory testing strategy was reported by 20.08 subjects. (Table 1) Logistic regression analyses revealed that compared to the non-qualified practitioners, qualified general practitioners had order ABT-737 higher odds of prescribing antibiotics rationally to patients suffering from watery/bloody diarrhea (OR = 3.01, p = 0.007) as well as any type of diarrhea (OR = 5.24, p = 0.019). Specialists with postgraduate qualifications did also show much higher (reference = non-qualified) odds of rationality regarding antibiotic use (for watery/bloody diarrhea: OR = 3.91,p = 0.001; for mucoid diarrhea: OR = 2.22,p = 0.023; for diarrhea overall: OR = 8.75,p = 0.002). Higher duration of practice was associated with increased likelihood of rational antibiotic use in case of watery/bloody diarrhea (OR = 2.87,p = 0.023). Practitioners working in the Governmental sector had considerably higher odds of rational antibiotic use (for watery/bloody diarrhea: OR = 5.11,p = 0.030; for diarrhea overall: OR = 11.08,p = 0.044) compared to those who were not attached to any healthcare institute. The odds of rationalPLOS ONE | DOI:10.1371/journal.pone.0123479 April 7,5 /Rational Management of DiarrheaTable 1. Distribution of the charac..Statistical AnalysisDistribution (frequency, proportion with corresponding standard errors) of the physicians’ characteristics, diarrhea-related knowledge and rationality of management were determined. Logistic regressions were conducted to measure the strength and direction of associations [Odds Ratios (OR), corresponding 95 confidence intervals (95 CI) and p values] between physicians’ characteristics/knowledge and rationality of diarrheal management. SAS version 9.2 was used for statistical analyses.ResultsSocio-demographic distribution and diarrhea-related knowledge (domain-wise and overall) of the 264 participating practitioners were presented elsewhere [23]. Briefly: most of them (92.05 ) were male, 53.03 had no recognized medical qualifications, 25.76 were medical graduates involved in general practice and 21.21 were specialists with postgraduate qualifications. Majority (72.35 ) were practicing for more than 10 years, 18.56 were not attached to any healthcare institution, while only 6.06 were working in Governmental hospitals. Different practitioners preferred different IVF for managing severely dehydrated diarrhea cases while only 17.80 and 18.18 respectively used ringer lactate or normal saline principally. Among the participants, 32.95 advised laboratory test of stool to identify the causative organism of diarrhea after initiating antimicrobial therapy and only 26.14 mentioned that for diagnosing the causative organism of diarrhea they advised stool/rectal swab culture. Proportions of participants having best knowledge about diarrheal disease (signs/symptoms), its occurrence/spread, management, prevention/control, cholera, and ORS were as low as: 15.53 , 25.76 , 16.29 , 44.70 , 7.58 and 14.39 respectively while only 19.32 practitioners had best overall knowledge regarding diarrhea. Only 20.08 were rational regarding overall laboratory testing strategy (advice and timing together). While treating cases of acute watery/bloody diarrhea, only 17.05 prescribed antibiotics rationally, for mucoid diarrhea this proportion was 24.62 and overall involving all types of diarrhea it was only 7.20 . Rational use of IVF was observed among 17.80 , 26.14 rationally advised laboratory investigations for diarrhea cases while rational laboratory testing strategy was reported by 20.08 subjects. (Table 1) Logistic regression analyses revealed that compared to the non-qualified practitioners, qualified general practitioners had higher odds of prescribing antibiotics rationally to patients suffering from watery/bloody diarrhea (OR = 3.01, p = 0.007) as well as any type of diarrhea (OR = 5.24, p = 0.019). Specialists with postgraduate qualifications did also show much higher (reference = non-qualified) odds of rationality regarding antibiotic use (for watery/bloody diarrhea: OR = 3.91,p = 0.001; for mucoid diarrhea: OR = 2.22,p = 0.023; for diarrhea overall: OR = 8.75,p = 0.002). Higher duration of practice was associated with increased likelihood of rational antibiotic use in case of watery/bloody diarrhea (OR = 2.87,p = 0.023). Practitioners working in the Governmental sector had considerably higher odds of rational antibiotic use (for watery/bloody diarrhea: OR = 5.11,p = 0.030; for diarrhea overall: OR = 11.08,p = 0.044) compared to those who were not attached to any healthcare institute. The odds of rationalPLOS ONE | DOI:10.1371/journal.pone.0123479 April 7,5 /Rational Management of DiarrheaTable 1. Distribution of the charac.
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