Prevalence, pattern and perceptions of self-medication in medical students

Background: The use of self-medication is highly prevalent in the community more so amongst the medical students. Self-medication can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms.Aims and Objectives: To study the prevalence and pattern of use of self-medication among medical students from first year to internship.Methods: This cross sectional study was carried out among under graduate medical students including interns of Smt. NHL Municipal Medical College, Ahmedabad during the period of March 2010 to May 2010. Results: Out of 747 students and interns enrolled, 685 responded (91.7%). Out of 685 respondents 564 (82.3%) reported self-medication within one year of recall period. Most common conditions/symptoms for self-medication in students were fever (72.7%), headache (69.1%), upper respiratory tract infections (64.1%) followed by others like body-ache, abdominal pain, diarrhoea etc. Over the counter drugs (84.2%) was the most common category of drugs used by all the students except first year students who used prescription only drugs more frequently (48.5%). Herbal and Ayurvedic drugs were also used as self-medication (17.8%); most frequently by the first year students (22.7%).Conclusion: The pattern of self-medication practice changes with time and advancement of knowledge

Glucocorticoids and neurodegeneration

Series: Endocrinology research and clinical developmentsGlucocorticoids (GCs) exert wide-spread actions in central nervous system ranging from gene transcription, cellular signaling, modulation of synaptic structure and transmission, glial responses to altered neuronal circuitry and behavior through the activation of two steroid hormone receptors, glucocorticoid receptor (NR3C1, GR) and mineralocorticoid receptor (NR3C2, MR). These highly-related receptors exert both genomic and non-genomic actions in the brain, which are context-dependent and essential for adaptive responses to stress resulting in modulations of behavior, learning and memory processes. Thus, GCs through their receptors are implicated in neural plasticity as they modulate the dendritic and synaptic structure of neurons as well as the survival and fate of newly-generated cells (neuro- and glio-genesis) in adult brain. GCs are also important in fetal brain programming as inappropriate variations in their levels during critical developmental periods are suggested to be casually related to the development of brain pathologies and maladaptive responses of hypothalamic-pituitary adrenal (HPA) axis to stress during adulthood. They regulate immune responses in brain, which have important consequences for neuronal survival. In situations of chronic stress and HPA axis dysfunction resulting in chronically high or low GCs levels, a multitude of molecular, structural and functional changes occur in the brain, eventually leading to maladaptive behavior. In fact, clinical studies suggest a causal relation of deregulated GC responses with development of neurodegenerative disorders such as Alzheimer´s (AD) and Parkinson‘s (PD) diseases. AD and PD patients have high levels of circulating cortisol while animal studies suggest that this chronic GC elevation participates in neurodegenerative processes in both AD and PD pathologies. This chapter will focus on the role of HPA axis and GCs on neurodegenerative processes involved in AD and PD pathogenesis.(undefined

Primary accumulation in the Soviet transition

The Soviet background to the idea of primary socialist accumulation is presented. The mobilisation of labour power and of products into public sector investment from outside are shown to have been the two original forms of the concept. In Soviet primary accumulation the mobilisation of labour power was apparently more decisive than the mobilisation of products. The primary accumulation process had both intended and unintended results. Intended results included bringing most of the economy into the public sector, and industrialisation of the economy as a whole. Unintended results included substantial economic losses, and the proliferation of coercive institutions damaging to attainment of the ultimate goal - the building of a communist society

Multicentricity of breast cancer: whole-organ analysis and clinical implications

We studied the spatial relationship within the breast between multicentric foci (MCF) and the primary tumour in 30 modified radical mastectomy specimens using Egan's correlated pathological-radiological method using 5 mm slices of the whole breast. The relative positions within the breast of the primary tumour and MCF were used to calculate the relative distribution of primary tumour and MCF in the four quadrants of the breast and the per cent breast volume that would be required to be excised to include all MCF. Nineteen (63%) breast harboured MCF. The relative distribution of primary tumour and MCF in the four breast quadrants was significantly different (P = 0.034). MCF were present beyond the index quadrant (25% of breast volume including the tumour) in as many as 79% (15/19) of breasts that harboured MCF; and in half the cases (15/30) when all breast were considered. This is in variance with the suggestion put forward previously that MCF are contained within the index quadrant in 90% of cases. Although the number of patients in the present series is small, the probability of our finding being due to play of chance is 1 in 1500. In a large series of breast conservation studies > 90% of early breast recurrences have been found to occur in the index quadrant. Our finding, that in half the patients (15/30) MCF are present in quadrants other than the index quadrant, suggests that MCF do not give rise to early breast recurrence

Chronic stress and glucocorticoids: from neuronal plasticity to neurodegeneration

Stress and stress hormones, glucocorticoids (GCs), exert widespread actions in central nervous system, ranging from the regulation of gene transcription, cellular signaling, modulation of synaptic structure, and transmission and glial function to behavior. Their actions are mediated by glucocorticoid and mineralocorticoid receptors which are nuclear receptors/transcription factors. While GCs primarily act to maintain homeostasis by inducing physiological and behavioral adaptation, prolonged exposure to stress and elevated GC levels may result in neuro- and psychopathology. There is now ample evidence for cause-effect relationships between prolonged stress, elevated GC levels, and cognitive and mood disorders while the evidence for a link between chronic stress/GC and neurodegenerative disorders such as Alzheimer's (AD) and Parkinson's (PD) diseases is growing. This brief review considers some of the cellular mechanisms through which stress and GC may contribute to the pathogenesis of AD and PD.The work was supported by Grants “PTDC/SAU-NMC/113934/2009,” funded by FCT, Portuguese Foundation for Science and Technology, and project DoIT, Desenvolvimento e Operacionalização da Investigação de Translação (N° do projeto 13853), funded by Fundo Europeu de Desenvolvimento Regional (FEDER) through the Programa Operacional Fatores de Competitividade (POFC). In addition, this work was also cofinanced by European Union FP7 Project SwitchBox (Nuno Sousa, Osborne F. X. Almeida) and the Portuguese North Regional Operational Program (ON.2 – O Novo Norte) under the National Strategic Reference Framework (QREN), through the European Regional Development Fund (FEDER). Sheela Vyas acknowledges grant support from Foundation de France, Physiopathology of Parkinson, France Parkinson and ANR Grant “ParkStrim” N° 13-BSV1-0013-02. Work in FT research group was supported by Agence Nationale de la Recherche (TIMMS and StressPsyco) and Fondation pour la Recherche Médicale, Grant no. DEQ20140329552

Two-Level Atom in an Optical Parametric Oscillator: Spectra of Transmitted and Fluorescent Fields in the Weak Driving Field Limit

We consider the interaction of a two-level atom inside an optical parametric oscillator. In the weak driving field limit, we essentially have an atom-cavity system driven by the occasional pair of correlated photons, or weakly squeezed light. We find that we may have holes, or dips, in the spectrum of the fluorescent and transmitted light. This occurs even in the strong-coupling limit when we find holes in the vacuum-Rabi doublet. Also, spectra with a sub-natural linewidth may occur. These effects disappear for larger driving fields, unlike the spectral narrowing obtained in resonance fluorescence in a squeezed vacuum; here it is important that the squeezing parameter $N$ tends to zero so that the system interacts with only one correlated pair of photons at a time. We show that a previous explanation for spectral narrowing and spectral holes for incoherent scattering is not applicable in the present case, and propose a new explanation. We attribute these anomalous effects to quantum interference in the two-photon scattering of the system.Comment: 10 pages, 17 figures, submitted to Phys Rev

Why reinvent the wheel: Let's build question answering systems together

Modern question answering (QA) systems need to flexibly integrate a number of components specialised to fulfil specific tasks in a QA pipeline. Key QA tasks include Named Entity Recognition and Disambiguation, Relation Extraction, and Query Building. Since a number of different software components exist that implement different strategies for each of these tasks, it is a major challenge to select and combine the most suitable components into a QA system, given the characteristics of a question. We study this optimisation problem and train classifiers, which take features of a question as input and have the goal of optimising the selection of QA components based on those features. We then devise a greedy algorithm to identify the pipelines that include the suitable components and can effectively answer the given question. We implement this model within Frankenstein, a QA framework able to select QA components and compose QA pipelines. We evaluate the effectiveness of the pipelines generated by Frankenstein using the QALD and LC-QuAD benchmarks. These results not only suggest that Frankenstein precisely solves the QA optimisation problem but also enables the automatic composition of optimised QA pipelines, which outperform the static Baseline QA pipeline. Thanks to this flexible and fully automated pipeline generation process, new QA components can be easily included in Frankenstein, thus improving the performance of the generated pipelines

Hodgkin's lymphoma masquerading as vertebral osteomyelitis in a man with diabetes: a case report

<p>Abstract</p> <p>Introduction</p> <p>Infection and malignancy often have common characteristics which render the differential diagnosis for a prolonged fever difficult. Imaging and tissue biopsy are crucial in making a correct diagnosis, though differentiating between chronic osteomyelitis and malignancy is not always straightforward as they possess many overlapping features.</p> <p>Case Presentation</p> <p>A 52-year-old Caucasian man was treated with antibiotics for his diabetic foot infection after a superficial culture showed <it>Staphylococcus aureus</it>. He had persistent fevers for several weeks and later developed acute onset of back pain which was treated with several courses of antibiotics. Radiographic and pathological findings were atypical, and a diagnosis of Hodgkin's lymphoma was made 12 weeks later.</p> <p>Conclusion</p> <p>Clinicians should maintain a suspicion for Hodgkin's lymphoma or other occult malignancy when features of presumed osteomyelitis are atypical. Chronic vertebral osteomyelitis in particular often lacks features common to acute infectious disease processes, and the chronic lymphocytic infiltrates seen on histopathology have very similar features to Hodgkin's lymphoma, highlighting a similar inflammatory microenvironment sustained by both processes.</p