Knowledge and practices in community regarding antibiotic usage

Background: One of the major causes of concern in medical world is rapid development of antibiotic resistance. World Health Organisation started an initiative in 2011 with a policy designed to curb this danger of antibiotic resistance. This study was designed to know the knowledge, attitude and belief of community regarding antibiotic use so that data can be generated in this region for the proper designing and implementation of awareness campaigns for the community.Methods: A single point cross sectional study was conducted in 1500 adults attending the Out Patient Department of a tertiary care hospital in Northern India. The tool used for the study was a predesigned questionnaire. The data was evaluated using descriptive statistical analysis.Results: In our study 92.8% participants admitted of having used an antibiotic at any time in their lifetime. The most common reason for use of antibiotics was common cold (36.2%). The most common antibiotic used by the participants was amoxycillin. The most common source of information regarding antibiotics and their use (63.2%) was physicians. 78.6% of the participants believed that they have awareness about rational use of antibiotics. 68.6% respondents were of the view that antibiotics are effective against both viral and bacterial infections. 52.3% of the participants believed antibiotics are not safe to use.Conclusions: The existence of a significant gap between practice of antibiotic usage and knowledge about their usage was found prevalently in the community. After noting the results of this study it is believed that there is a dire necessity to take steps to curb the menace of rapid development of resistance to antibiotics.

Patterns and practice of self-medication among children presenting with acute respiratory tract infection or diarrhoea

Background: Self-medication is quite prevalent in many parts of the world and has led to wastage of precious manpower and time due to many adverse consequences. As a result there is great burden on a country both financially as well as health point of view. The purpose of this study was to identify the pattern and practice of self-medication among children presenting with Acute Respiratory Tract Infection or Diarrhoea in a tertiary care hospital of northern India.Methods: A single point cross sectional study was conducted in 500 parents accompanying the children in the Paediatrics out Patient Department (OPD) of a Medical College in Northern India. The tool used for the study was a predesigned questionnaire. The data was evaluated using descriptive statistical analysis.Results: Out of 500 subjects 486 were found eligible for enrolment. Out of these eligible subjects, 308 (63.3%) parents reported history of self-medication. 143 (51.3%) male children were administered self-medication. This number was proportionately higher in females (79.7%). The drug most commonly administered were non-steroidal anti-inflammatory drugs (64.3%) followed by antibiotics and cough and cold preparations. The most common source of drug procurement was the left over drugs from previous treatment (75.2%) followed by purchase from a medical store. Most common reason for self-medication was previous experience with the prescribed drugs (76.6%).Conclusions: The problem of self-medication of prescription only drugs is quite prevalent in this part of the country. As self-medication has its complications and adversities proper orientation and awareness of the population about self-medication is of utmost importance for proper utilization of resources and manpower. Further the government agencies should ensure proper implementation and supervision of laws related to sale of ‘Prescription only drugs’

Introduction of clinical audit in obstetrics for undergraduate medical students

Background: Clinical audit is becoming increasingly important in the healthcare system to ensure a high quality of patient care. Involving the undergraduate medical students in the audit process will help them to understand the subject better and will stimulate them to critically appraise a medical issue. Clinical audit is a hands-on practice of data collection, comparison of current clinical practice with standard and find root cause analysis-based intervention to implement change ideas. Aim and objectives of current study were to introduce audit as a teaching tool in clinical posting of obstetrics and evaluate its impact and acceptability. Methods: Final year MBBS students were enrolled for the study. The caesarean section was selected as the topic for audit. A pre-test was given before the introduction of Clinical audit. Participants were trained to do a systematic clinical audit including analyzing the collected data. They worked in small groups along with a faculty supervisor. A post-test was taken after one month. Likert scale was used to evaluate the acceptability of this tool by students. Results: A total of 50 MBBS students of the final semester completed the pre-test, training to use clinical audit and the post-test. The results of pre-test and post-test were compared and a statistically significant improvement was found in the performance of students. This method was found to be an acceptable tool for clinical teaching by 98% of the students. Conclusions: Final year MBBS Students performed better when clinical audit was used as a teaching tool, which was also well accepted by them

Visual evoked potentials in children with type 1 diabetes mellitus

Background: Insulin-dependent (type 1) diabetes mellitus is associated with different degrees of neuropathies affecting peripheral as well as central neural pathways. The subclinical neurological involvement in diabetic children can be assessed by changes appearing in the electrophysiological parameters like Visual Evoked Potentials (VEPs). The objective of the study was to assess the effect of type I diabetes melitus on the visual evoked potentials in children.Methods: This cross-sectional case-control study was done on 30 children with type 1 diabetes mellitus of minimum two years duration as cases and 30 age and gender matched euglycemic children with normal HbA1c taken as controls. Visual Evoked Potentials (VEPs) were done on both the groups of children and the latencies (ms) of waves -N75, P100, N145 and amplitude (μV) of wave P100 were recorded. The data was compiled in the pre-designed proforma and statistically analysed using student t-test.Results: The increase in the mean latencies of waveforms of VEPs N75, P100 and amplitude P100 were found to be highly significant statistically (p<0.001) in both the eyes among the children with type 1 diabetes mellitus. The mean latency of waveform N145 was found to be statistically insignificant in the two groups (p>0.05).Conclusions: The type 1 diabetes does affect the visual pathways in children. Visual Evoked Potentials are helpful in the detection of early changes in the conduction across the neural pathways in the sub-clinical diseases

Combining traditional embryology lectures with technology and perception of students toward it

Background: Technology-enhanced learning is reliable, established, and effective teaching tool for better understanding of the subject. This study addresses an important issue in medical education, namely, the enhancement of the widely criticized lecture style of teaching by engaging students more actively during class through the use of videos or animations. This study describes the development, implementation, and evaluation of a traditional anatomy lecture series combined with technology. Aim and Objectives: The aim of the study is (a) to combine three-dimensional (3D) videos and animations with traditional embryology lectures and (b) to evaluate the 1st-year MBBS students' perception about this method of learning of embryology. Methodology: This qualitative study was conducted in the Department of Anatomy at Guru Gobind Singh Medical College, Faridkot, during the theory classes of embryology over a period of approximately 3 months among 100 1st-year MBBS students. The students were shown 3D videos and animations of embryology during traditional didactic lecture to explain all the aspects of the development of different systems of the body in 25 classes, of 1-h duration each. Feedback was taken using a structured questionnaire to know the perception of students toward this exercise of using technology during lecture of embryology. Results: A total of 100 MBBS first professional students took part in the study and submitted questionnaire. The students were satisfied with this method of technology-enhanced learning and described better understanding of the concepts with improved learning. More than 90% of the students found that combining 3D videos and animations with traditional lecture helped in solving the confusion and misconceptions regarding topic and did make the topic more interesting. They further added that they wanted to have such type of technology (videos)-enhanced lectures in all other topics of anatomy and in other subjects as well. Conclusions: Technology used in the form of 3D videos and animations changed their attitude toward learning and their learning was improved. It provided satisfaction to students in terms of better learning and understanding of the subject

Knowledge and practices in community regarding antibiotic usage

Background: One of the major causes of concern in medical world is rapid development of antibiotic resistance. World Health Organisation started an initiative in 2011 with a policy designed to curb this danger of antibiotic resistance. This study was designed to know the knowledge, attitude and belief of community regarding antibiotic use so that data can be generated in this region for the proper designing and implementation of awareness campaigns for the community.Methods: A single point cross sectional study was conducted in 1500 adults attending the Out Patient Department of a tertiary care hospital in Northern India. The tool used for the study was a predesigned questionnaire. The data was evaluated using descriptive statistical analysis.Results: In our study 92.8% participants admitted of having used an antibiotic at any time in their lifetime. The most common reason for use of antibiotics was common cold (36.2%). The most common antibiotic used by the participants was amoxycillin. The most common source of information regarding antibiotics and their use (63.2%) was physicians. 78.6% of the participants believed that they have awareness about rational use of antibiotics. 68.6% respondents were of the view that antibiotics are effective against both viral and bacterial infections. 52.3% of the participants believed antibiotics are not safe to use.Conclusions: The existence of a significant gap between practice of antibiotic usage and knowledge about their usage was found prevalently in the community. After noting the results of this study it is believed that there is a dire necessity to take steps to curb the menace of rapid development of resistance to antibiotics.

Impact of socioeconomic status of family on the birth weight- A cross sectional study from Eastern India

Introduction: Despite a lot of progress in the field of neonatology in last few years, low birth weight babies still pose a challenge for an optimal outcome. Maternal socioeconomic status and malnutrition is directly or indirectly linked to the birthweight. We intended to study the effect of socioeconomic status of family with birthweight in eastern part of India. Objective: To assess the effect of socioeconomic status of family on birth weight and to assess the effect of anemia on birthweight. Materials and Methods: A cross-sectional study was conducted in Gouri Devi Institute of Medical Sciences and Hospital, Durgapur, West Bengal, from 1st March 2019 to 28th February 2020. Data was collected from the mothers who visited the Paediatrics OPD with their child during the study period. Mothers were asked to fill a pre-designated case record form. Details of antenatal, natal and postnatal records were sought and noted. For the purpose of assessment of socioeconomic status, education, occupation and income of family were recorded. Socioeconomic status family were classified in to 3 major categories; lower (lower and upper lower), middle (lower middle and upper middle) and upper as per modified Kuppuswamy classification. Maternal nutrition status was assessed by body mass index (BMI) and anemia. Results: Out of the 229 babies, 79 babies had low birthweight and 150 babies had normal birthweight. 35.5% of babies were found to have low birthweight. Babies born to mother with primary education (68.55%) were found to have more LBW babies than with higher education. Twenty eight (35.44%) LBW babies belong to middle class (class II and class III) and 51(64.56%) LBW babies were from lower class (P<0.05). Mothers of 194 (84.71%) out of 229 babies had anemia. Similarly only 5(6.33%) LBW babies belong to non-anemic mother where as 74(93.67%) of LBW babies were from mothers with low hemoglobin. Anemic mothers were more likely to deliver LBW baby. Conclusion: Low maternal education, low socio-economic status and maternal anemia were associated with increase in the risk of low birth weight babies

Visual evoked potentials in children with type 1 diabetes mellitus

Background: Insulin-dependent (type 1) diabetes mellitus is associated with different degrees of neuropathies affecting peripheral as well as central neural pathways. The subclinical neurological involvement in diabetic children can be assessed by changes appearing in the electrophysiological parameters like Visual Evoked Potentials (VEPs). The objective of the study was to assess the effect of type I diabetes melitus on the visual evoked potentials in children.Methods: This cross-sectional case-control study was done on 30 children with type 1 diabetes mellitus of minimum two years duration as cases and 30 age and gender matched euglycemic children with normal HbA1c taken as controls. Visual Evoked Potentials (VEPs) were done on both the groups of children and the latencies (ms) of waves -N75, P100, N145 and amplitude (μV) of wave P100 were recorded. The data was compiled in the pre-designed proforma and statistically analysed using student t-test.Results: The increase in the mean latencies of waveforms of VEPs N75, P100 and amplitude P100 were found to be highly significant statistically (p<0.001) in both the eyes among the children with type 1 diabetes mellitus. The mean latency of waveform N145 was found to be statistically insignificant in the two groups (p>0.05).Conclusions: The type 1 diabetes does affect the visual pathways in children. Visual Evoked Potentials are helpful in the detection of early changes in the conduction across the neural pathways in the sub-clinical diseases