Decoding neonatal chest radiographic patterns of disease: retrospective analysis from a tertiary care hospital

Background: To evaluate chest radiographic patterns in neonatal respiratory distress using a predesigned performa and algorithm and to correlate results with the clinical diagnosis.Methods: A retrospective review was done of bedside chest radiographs acquired over a month for respiratory distress from the neonatal intensive care unit. The radiographs were systematically evaluated according to a predesigned performa and algorithm. A presumptive radiographic diagnosis was assigned to each patient based on the combination of radiographic features. Radiographic diagnosis was compared with the clinical diagnosis. The most important diagnostic features were outlined.Results: The radiographic diagnosis correlated with clinical diagnosis in 93.3% of cases. Most common radiographic feature was pulmonary air space opacity (n=21). Air space opacity without any mediastinal shift in absence of any compensatory factors was a reliable diagnostic feature for pneumonic consolidation, which was the most common diagnosis (n=10). Bilateral granular lung fields were a specific indicator of respiratory distress syndrome. Flattening of domes of diaphragm was the most frequent feature for hyperinflation. Bilateral hyperinflation could be accurately used to diagnose bronchiolitis in all but one case (n=4/5). Pleural complications were accurately diagnosed.Conclusions: Systematic evaluation of neonatal chest radiographic patterns of disease has a high diagnostic accuracy

Impact of educational intervention on the awareness of undergraduate medical students towards teratogenicity: an observational study

Background: The term teratogenicity is defined as any morphological, behavioral or biochemical effect induced during embryonic life or fetal life detected at birth or later. the factors that lead to teratogenicity include both non-genetic and genetic factors. The objective of the present study was to assess the impact of educational interventions on the awareness of undergraduate medical students towards teratogenicityMethods: The present study was a questionnaire-based comparative observational study carried out at Department of Pharmacology and Therapeutics, Government Medical College, Jammu (J&K) for a period of three months from 1st November 2017 to 31st January 2018. The questionnaire was designed and validated by conducting pilot study on a sample of ten students. The questionnaire comprised of two main parts. The first part comprised of questions pertaining to the demographic profile of the students and second part consisted of questions assessing the students’ knowledge and awareness towards teratogenicity. The scoring of the assessment of the performance of the students regarding knowledge of various aspects of teratogenicity was done before and after the educational intervention and was compared using paired t-test.Results: A total of 134 second year MBBS undergraduate students participated in the study. Mean age of students was 19.32±0.82 years. In the present study it was found that before the educational intervention about 98.5% of the students and after the intervention all the students were aware of the term teratogenicity. About 69.4% of students knew about all the causes that lead to teratogenicity but after the intervention about 76.1% of the students knew about it. Also, the percentage of students who knew about the name of two teratogenic drugs and two teratogenic defects associated with drugs were only 31.3% and 22.3% respectively. After the educational intervention it increased to 61.9% and 52.2% respectively.Conclusions: In the present study, it was found that after the educational intervention, there was a significant improvement in the mean knowledge score of the students. This reflects the need of early exposure of students to this important issue of teratogenicity

Self-medication in ophthalmology - a northern Indian tertiary hospital experience

Background: The objective of the study was to identify practice and pattern of self-medication use among new patients attending ophthalmology OPD in a tertiary care hospital of north India. Self-medication practice is a common phenomenon all over the world but it has been reported to be very common in the developing countries especially in India. When consumers self-medicate without consulting the eye care giver, the issues of safety and irrational use of drugs arise.Methods: A cross-sectional questionnaire based, observational study was planned among the patients reporting for the first time to Ophthalmology OPD in ASCOMS, Jammu. The patients enrolled in the study were randomly selected in the age group ≥18 years. Detailed history regarding self-medication prior to reporting to OPD was obtained. A questionnaire elucidating details of self-medication regarding history of ocular self-medication, type of ocular medication used, their reasons for resorting to ocular self-medication etc. was provided to them. All participants were informed about the scope and purpose of the study. An informed consent was obtained in every case prior to being given the questionnaire.Results: A total of 296 responders were interviewed. Among these 122 (41.2%) admitted to have used eye medicines before coming to hospital. Redness in 38 (31.1%) cases was the most common complaint for which the patients opted self-medication. 49 (40.2%) patients did not know what drug they had used. Among the various drugs used, the commonest was the antibiotic eye medication in 33 (27%) patients followed by steroids 13 (10.7%). Among the responders 9 (7.3%) experienced side-effects after self-medication. Main factors influencing self-medication were advice from friends/relatives, living far from hospital and high cost of treatment at the hospital.Conclusions: Self-medication with eye medicines is common among the population interviewed. Educating the public about the dangers of self-diagnosis and treatment, possibly leading to delay in detection of more serious underlying ailments is essential

Evaluation of awareness about pharmacoeconomics in postgraduate students of a tertiary care teaching hospital: a questionnaire based observational study

Background: Pharmacoeconomics identifies, measures and compares the costs and consequences of drug therapy to health care systems and society. The per capita income of all middle class people is limited and the drug prices are growing extensively. Therefore, it is the responsibility of the health-care professionals to balance both cost and quality of treatment. Hence, this study was planned among the postgraduate students who form the major part of health care delivery system to assess their awareness about pharmacoeconomis.Methods: This was a questionnaire based cross-sectional study. Self-administered questionnaire was distributed among 72 residents, out of which 61 completely filled questionnaires were finally used for statistical analysis. The questionnaire contained questions relating to awareness, knowledge, method of application and students’ attitude about pharmacoeconomics.Results: The willingness to participate in the study among postgraduates was extremely poor. Those who have participated, almost 39% of participants were having awareness about the topic. Nearly 31 % of the participants were having knowledge regarding pharmacoeconomics and around 21 % of participants have learnt the method of application in various aspects.Conclusions: Study has revealed that that the knowledge and perception level of postgraduates in day to day use of pharmacoeconomic concepts are poor and limited. Therefore, it is very necessary to make them aware about the concept of pharmacoeconomics by incorporationg it in their medical curriculum and by conducting CMEs and Workshops on pharmacoeconomics

Evaluation of usefulness of seminar as a learning tool at medical undergraduate level

Background: Teaching methods has a major role to play in making a subject innovative, interesting and participatory for the students. In India still teaching is controlled by teacher centered classroom method. Apart from this one of the method adopted is organizing seminars for the students. Knowledge acquisition through seminars forms an essential part of medical training programme. The idea behind the seminar system is to familiarize students more extensively with the methodology of their chosen subject.Methods: A questionnaire was prepared containing ten questions and 1000 MBBS students of second, pre-final, final professional and 200 faculty members, were asked to fill up the questionnaire. It included ten questions.Results: Results showed that seminar methods of teaching-learning, is effective way of learning, which is relevant to self-development and is also interactive. It improves communication skills.Conclusions: Many of the students feel that this technique of seminar programme is helpful for them in the long run. Thus teaching by way of seminar could be an effective learning method as it involves the three major domains of teaching i.e., cognitive, affective and psychomotor skills and is thus well -accepted among the medical students

Urinary bladder agenesis with bilateral single system vaginal ectopic ureters in adult

Agenesis of urinary bladder is an extremely rare condition with only 60 cases and 22 live births being reported previously. Ureteric ectopia is a must for survival. We present a unique case of bladder agenesis detected in adulthood where bilateral single system ureters were draining ectopically in a grossly dilated vagina in normally developed female genital tract

Knot Ready: Lessons From India on Delaying Marriage for Girls

Examines trends in and predictors of age at marriage. Assesses the effectiveness of ten program and policy interventions, underlying factors, and lessons for expanding viable strategies: empower girls, mobilize communities, and influence decision makers

Study of prescription pattern of drugs used in the treatment of osteoarthritis in a tertiary care teaching hospital: an observational study

Background: Osteoarthritis(OA) is a major cause of chronic pain and lower extremity disability among the elderly due to its predilection for lower extremity joints such as the knee and hip. Although Paracetomol is the initial drug of choice, NSAIDS are also frequently used in the symptomatic relief of osteoarthritis. But still, there is a need for safe and effective alternative treatments which would provide both symptomatic improvement and disease modifying effects in OA. The primary objective was to study the prescribing pattern of drugs used in the treatment of osteoarthritis.Methods: A cross-sectional, prospective, observational study was conducted on newly diagnosed as well as old treated patients with osteoarthritis from orthopaedic outpatient department in a tertiary care teaching hospital. A total of one hundred and eighty-eight patients were enrolled after screened for the inclusion and exclusion criteria. Data was recorded in a specially designed proforma which include information regarding the demographic profile of the patients and about the pattern of drugs prescribed.Results: Out of one hundred eighty-eight patients who were affected with Osteoarthritis, females (57.9%) were more commonly affected than males (42%). OA knee (77%) either unilateral or bilateral was most commonly affected, followed by hip joint, spine and other joints. NSAIDS were more frequently prescribed in 76.6% patients than paracetamol which was prescribed in only 34 % of patients and that only in combination with NSAIDS and opioids. Various other drugs were also used as adjunct therapies that included gastroprotective agents in 49% of patients, Calcium in 54% of patients, Vitamin D3 supplements in 51% of patients and symptomatic slow acting drugs for OA (SYSADOA) which included diacerin and glucosamine sulfate as combination in 11% of patients.Conclusions: Our study showed Osteoarthritis knee being most common among female patients. Paracetamol and SYSADOA being under prescribed and NSAIDS are the most frequently used drugs in OA. National drug policy is needed to rationalize the drug use and bring awareness among the prescribing doctors.

A study on determinants of underreporting of adverse drug reactions among resident doctors

Background: Adverse Drug Reactions (ADRs) are global problem with significant morbidity and mortality. Health care providers/professionals (HCPs) play a critical role in ADR surveillance. However, only 6% of all ADRs are reported and under-reporting acts as great impedance in exchange of drug information. Thus, spontaneous reporting of suspected adverse drug reactions requires greater commitment from healthcare professionals. The aim was to determine the reasons of underreporting of ADRs among resident doctors.Methods: This was a cross-sectional observational study with self-administered questionnaire assessing the reasons for underreporting of ADRs among resident doctors.Results: Very low level of awareness about ADR reporting was found among doctors. Eighty eight percent of doctors did not know the authority and the procedure for ADR reporting. About 32.8% were not sure with the reaction and the drug, while 46.3% doctors felt that there is no need of reporting the recognized reactions again. Other factors responsible for under reporting were lack of time in 73% and cumbersome procedure in 45% of the participants.Conclusions: A poor level of awareness of pharmacovigilance was seen among doctors. Measure to improve awareness, accessible systems for reporting and effective National Programme are required to improve reportin

A study on awareness about package inserts among postgraduate medical students: an observational questionnaire based study

Background: A package insert is a document approved by the administering licensing authority, which is provided with the package of a drug. A good package insert can prove to be of immense help to doctors as they are evidence based and are updated from time to time. The objective to study the awareness about package inserts among postgraduate medical students.Methods: The present study was a cross-sectional observational study carried out on 68 postgraduate medical students of Acharaya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu (J & K) in the month of February 2017 after taking approval from the institutional ethical committee. Pre-validated self-administered questionnaire was used to elicit responses from the students. The questionnaire consisted of specified questions regarding knowledge and opinion about package inserts.Results: In the present study, 86.7% of the students understand the relevance of Package inserts (PIs). About 72% of the students think that PIs are a necessary add-on to drug information and 70.6% of the students think that information given on package inserts is necessary for the patients. However, only 2.9% of the students had the knowledge of Drug Acts governing the information to be provided on PIs in India. About 86.8% of the students think that PIs should also be in regional language apart from in English language.Conclusions: It was found from the present study that the majority of the postgraduate students were aware about the package inserts available with the medicines but the information provided on package inserts was not optimally used by them. To achieve the target of optimally utilization of information provided in the package inserts, the PIs should be designed by considering the needs and information of two differently educated target groups i.e; patients and doctors