A study on knowledge and practices of over the counter medications among 1st year medical students

Background: Self-medication is widely practiced worldwide and often considered as a component of self-care. Selfmedication assumes a special significance among the medical students as they are the future medical practitioners and have a potential role in counselling the patients about the advantages and disadvantages of self-medication. Self-medication assumes a special significance among the medical students as they are the future medical practitioners. Medical students also differ from the general population because they are well-exposed to the knowledge about diseases and drugs. Therefore the present study was taken up to assess the extent of knowledge and practices of over the counter (OTC) drugs among the first year medical students in a tertiary care teaching hospital.Methods: A descriptive, cross sectional, non-interventional, observational study was conducted from November 2017 to January 2018 among 246 first year medical students. The data analyzed using descriptive statistics with percentages and averages using Statistical Package for Social Science (SPSS).Results: In the present study, it was found that 86% students practiced self-medication. Most common conditions for taking self-medication with OTC was fever (89%) followed by cough and cold (75%). 15% of them experienced adverse reactions on OTC self-medicated drugs. The main source of information during self-medication was reading material (56.3%) followed by advice from seniors/pharmacist (43.7%).Conclusions: Self-medication is widely practiced among undergraduate medical students. In this situation, we should educate the students about advantages and disadvantages of self-medication of over the counter drugs

A prospective study to evaluate oral iron preparations in antenatal women at a tertiary care hospital

Background: Iron deficiency is the most common cause of anemia in pregnancy worldwide. It can be mild, moderate or severe. Severe anemia can have very serious consequences for mothers and babies. Pregnant women requiring medication represent a challenge to healthcare providers to avoid any teratogenic risk to foetus. The purpose of this study was to provide information about the most effective iron preparations prescribed to pregnant women and to evaluate the haemoglobin status before and after oral iron therapy.Methods: This was a Prospective observational study conducted in the Department of Obstetrics and Gynaecology, Rajarajeswari Medical College and Hospital, between October 2013 and March 2014.This study was conducted by reviewing the antenatal care Outpatient department case papers of 200 pregnant women who were anaemic.Results: Demographic profile, detailed medical history and drug intake in current pregnancy was noted. The prescription pattern was assessed. Of the three common iron preparations prescribed, Ferrous sulphate was the most common preparation. Findings of our study showed that all pregnant anaemic women included in the study were provided with iron and folic acid therapy and the most effective oral iron preparation was Ferrous sulphate.Conclusions: Present study shows that ferrous sulphate is the most common iron preparation prescribed. Ferrous sulphate and ferrous fumarate preparations showed better improvement in Hb levels. Anaemia is common among all pregnant women and therefore it raises the concern about high morbidity and mortality associated with pregnancy outcome. This can be minimized by educating pregnant women about importance of balanced diet and utilization of antenatal facilities even during early pregnancy.

Pattern of drug utilization in pediatric out patient department of a tertiary care teaching hospital

Background: Drug utilization studies have special significance among paediatric age groups as infant and children represent about 42% of the population in developing countries. This is the vital period of rapid growth and development. Therefore, drugs should be used very cautiously and rationally among these sub groups. The present study is conducted to analyse the prescribing pattern of drugs in paediatric age group for various illnesses. Methods: It was a prospective observational study, conducted in paediatric outpatient department of Raja Rajeswari medical college and research hospital for a period of 6 months after obtaining approval from institutional ethical committee. Descriptive statistical was used to determine the frequency, percentages, mean and standard deviation.Results: In the present study, fever (30.8%) followed by respiratory diseases were most common diseases seen. The commonly used drugs include antipyretics (66%), antimicrobials (53.6%), cough syrups (34.4%), antihistaminic (31.2%) and nasal decongestants (23.2%). Prescribing indicator shows existence of polypharmacy. Prescribing drugs by generic name was seen only in 8.1% and 47.82% of the drugs were prescribed from EDL. The frequency of use of injectables in our study was 5.8%. Conclusions: Irrational use of antibiotics and polypharmacy needs to be curbed. Prescribing drugs in their generic name and prescribing drugs from EDL need to be promoted. The present prescribing pattern can be improved by advocating rational drug prescribing, patient education and improving hospitals

Study on assessment of awareness about concepts in undergraduate pharmacology curriculum among clinicians in a tertiary care teaching hospital

Background: Rational prescribing forms the corner stone of successful implementation of rational drug use. To boost the cause of rational use of Medicine, the P-drug concept was given in late nineties. The idea was to make Physicians familiar with few personal drugs chosen from National Essential drug list based on efficacy, safety, suitability and cost. The present study was conducted to assess the awareness of clinicians about basic pharmacological concepts.Methods: It is a cross sectional study with a study population of 100, conducted in RRMCH for a period of one month. It is a questionnaire based study involving clinicians and post graduates working in this hospital. Descriptive statistical analysis has been carried out in the present study.Results: In our study, 38% of physicians were aware of the term Essential drugs and 26% of doctors prescribed drugs from National Essential drug list. 56% of respondents were aware of term rational drug use but only 1/3 of them were aware of adverse effects, drug interactions of the drugs they prescribed. Majority of physicians (85%) used standard text book as the source of drug information.Conclusions: Lack of knowledge among physicians about new concepts like p-drug, rational drug use and essential drugs points towards need for having more CMEs on basic pharmacological concepts

A study to compare the efficacy of methotrexate alone vs. methotrexate plus pioglitazone in the management of plaque-type psoriasis

Background: Psoriasis is a common skin condition affecting a huge segment of global population. So far, the treatment has been confined to drugs like methotrexate, cyclosporine and oral retinoids which are highly toxic for long term usage and requires a novel drug that is safer.Methods: Cases of plaque type psoriasis are divided into two arms and treated with methotrexate monotherapy in group A and methotrexate plus pioglitazone combination therapy in group B. The outcome of the study is analyzed using PASI score and DLQI scoring systems.Results: Group A and Group B showed significant reduction in the PASI and DLQI scores. Group B was better in terms of efficacy (p<0.05) when compared to Group A. There was no significant difference between the groups in terms of DLQI scoring. Both groups had similar side effect profile.Conclusions: Pioglitazone which acts by sensitizing the cells to insulin poses no risk of hypoglycemia. It is more specific for the treatment of psoriasis as it targets the keratinocytes. Present study suggests a possible role as an adjuvant in the treatment of psoriasis, and could pave way for low dose methotrexate and thereby reducing the potential side effects

The prescribing pattern for the management of dengue fever in pediatric patients of a tertiary care hospital: an observational study

Background: Dengue fever is a mosquito borne viral infection which has become a global health hazard, especially in tropical and subtropical areas. Children have higher risk of developing severe forms of dengue fever, however, studies show that paediatric complications/fatalities from dengue fever are potentially avoidable by proper management. Data about drug usage patterns for dengue are particularly lacking, especially in the paediatric age group, therefore this study will help facilitate the rational use of drugs and aid in establishing a more specific management for dengue fever. The objective of the present study was to identify the prescribing pattern of dengue fever in paediatric inpatients admitted to RajaRajeswari Medical College and Hospital and assess according to the WHO core prescribing indicatorsMethods: This prospective observational study took place from March 2017 to September 2017 in the paediatric general wards. Data was collected from case files of NS1 positive patients of both genders between 1-18years. Data was analysed using descriptive statistics and expressed as percentages, means and standard deviations. The prescription pattern was analysed using the prescribing indicators mentioned in the World Health Organization core drug use indicators.Results: Total of 300 drugs were prescribed for 110 prescriptions that were analysed excluding IV fluids and blood products. Mean number of drugs prescribed was 2.7±0.8. Drugs prescribed by a generic name was 7.33%. Patients prescribed an antibiotic was 12.73%. Patients prescribed with an injection was 62.72% Majority of drugs prescribed in this study come from essential medicines list created by regulatory bodies. Intravenous fluids were administered to all patients with majority receiving normal saline (60.9%).Conclusions: Mainstay of treatment of dengue fever for paediatric patients is symptomatic along with focus on fluid management. Majority of drugs prescribed are from essential medicines lists formed by regulatory bodies. With dengue infections being a worldwide health hazard, more studies are needed to facilitate rational use of drugs in this disease

A comparative study on efficacy of nepafenac and flurbiprofen in maintenance of intraoperative mydriasis during cataract surgery: an open label randomized controlled trial

Background: Surgery on the ocular tissue brings about activation of phospholipase A3 thereby releasing prostaglandins and leukotrienes. Prostaglandins bring about meiosis during surgery, changes in IOP, conjunctival hyperaemia. Newer topical NSAID’s Nepafenac and Flurbiprofen are potent inhibitors of the cyclooxygenase enzyme thereby inhibiting the biosynthesis of prostaglandins. Objective of this study was to compare the efficacy of preoperative use of topical Nepafenac (0.1%) and Flurbiprofen (0.03%) in maintenance of intraoperative mydriasis during cataract surgery.Methods: A randomised, comparative study was performed on 104 patients, 52 were allocated in each group and were given either of the topical NSAID’s Nepafenac or Flurbiprofen prior to cataract surgery. Pupillary diameter was measured at the beginning and at the end of the surgery and the values were compared between the groups. Mean and standard deviation was calculated and between two groups comparison was done using students t-test.Results: The mean pupillary diameter of the two groups were comparable at the beginning of surgery (p=0.34). The mean change in the pupillary diameter was 1.86±0.71mm in the Nepafenac group and 1.77±0.72mm in the Flurbiprofen group. There was no statistically significant difference among both the groups in maintenance of intraoperative mydriasis (p=0.47).Conclusions: Pre-operative use of Nepafenac and Flurbiprofen were equally effective in preventing meiosis during cataract surgery

Study on antihyperglycemic effect of bromocriptine in dexamethasone induced hyperglycemic wistar rats

Background: Diabetes mellitus is a chronic metabolic disorder that develops due to insulin deficiency or insulin resistance. Recent animal and human studies have reported bromocriptine to be effective in the management of type 2 diabetes mellitus. The present study was done to evaluate the antihyperglycemic effect of bromocriptine in dexamethasone induced hyperglycemic rats.Methods: Male wistar rats were used and divided into 5 groups. Dexamethosone was used to induce hyperglycemia in group B-E. Group A was the untreated control group, group B was the standard control group, group C was the oral 10 mg/kg of bromocriptine dissolved in 0.9% normal saline, group D was the oral 20 mg/kg metformin dissolved in 0.9% normal saline, group E was the oral 10 mg/kg bromocriptine+20 mg/kg metformin dissolved in 0.9% normal saline. Fasting blood glucose, post prandial blood glucose and body weight was estimated on day 1, 15, 30.Results: It was seen that dexamethasone induced hyperglycemia and increase in body weight in male wistar rats, which were significantly controlled by oral bromocriptine and bromocriptine with metformin combination.Conclusions: Results obtained from this study showed that bromocriptine can be a promising drug with novel mechanism to treat type 2 diabetes mellitus

A NEW METHOD DEVELOPMENT AND VALIDATION FOR ESTIMATION OF PARACETAMOL IN PHARMACEUTICAL DOSAGE FORM BY REVERSE PHASE-HIGH PERFORMANCE LIQUID CHROMATOGRAPHY

Objective: An accurate, simple, reproducible and sensitive method for the determination of paracetamol in pharmaceutical dosage form was developed and validated using a reversed-phase C18 column (250 mm X 4.6 mm i. d, 5 µm particle size) with isocratic elution.Methods: A mixture of Acetonitrile: 10 mM potassium dihydrogen orthophosphate buffer (15:85 v/v), pH 2.5 was used as a mobile phase at the flow rate of 1.0 ml/min and detector wavelength at 210 nm. The retention time of paracetamol was found to be 5.7 minutes (min). The method was statistically validated for the linearity, accuracy, precision and robustness.Results: The linearity of paracetamol was in the range of 25.00 to 60.00µg/ml. This method showed an excellent linear response with the correlation coefficient (R2) value of 0.999 for the paracetamol. The recovery of the drug was ranged from 99.51 to 100.68%. An intra-day and inter-day precision study of the new method was less than the maximum allowable limit (% RSD&lt;2.0).Conclusion: The proposed method was cost effective, which can be used for the estimation of paracetamol in bulk and in solid dosage forms.Â

Extent of knowledge and attitudes on plagiarism among undergraduate medical students in South India - a multicentre, cross-sectional study to determine the need for incorporating research ethics in medical undergraduate curriculum

BACKGROUND: Undergraduate medical students in India participate in various research activities However, plagiarism is rampant, and we hypothesize that it is the lack of knowledge on how to avoid plagiarism. This study’s objective was to measure the extent of knowledge and attitudes towards plagiarism among undergraduate medical students in India. METHODS: It was a multicentre, cross-sectional study conducted over a two-year period (January 2018 – December 2019). Undergraduate medical students were given a pre-tested semi-structured questionnaire which contained: (a) Demographic details; (b) A quiz developed by Indiana University, USA to assess knowledge; and (c) Attitudes towards Plagiarism (ATP) questionnaire. RESULTS: Eleven medical colleges (n = 4 government medical colleges [GMCs] and n = 7 private medical colleges [PMCs]) participated. A total of N = 4183 students consented. The mean (SD) knowledge score was 4.54 (1.78) out of 10. The factors (adjusted odds ratio [aOR]; 95% Confidence interval [CI]; p value) that emerged as significant predictors of poor knowledge score were early years of medical education (0.110; 0.063, 0.156; < 0.001) and being enrolled in a GMC (0.348; 0.233, 0.463; < 0.001).The overall mean (SD) scores of the three attitude components namely permissive, critical and submissive norms were 37.56 (5.25), 20.35 (4.20) and 31.20 (4.28) respectively, corresponding to the moderate category. CONCLUSION: The overall knowledge score was poor. A vast majority of study participants fell in the moderate category of attitude score. These findings warrant the need for incorporating formal training in the medical education curriculum