Study on knowledge, attitude and practices with respect to antibiotic use among medical students

Background: Antibiotic resistance has emerged as a serious global problem. Irrational prescribing of antibiotics is one of the key factors responsible for the development of antibiotic resistance. As today’s medical students will be the future prescribers their awareness regarding antibiotic resistance and rational prescribing of antibiotics is very much important. The main objective of the study was to evaluate the knowledge, attitude and practices of the medical students towards antibiotic use.Methods: A cross-sectional questionnaire-based study was conducted involving the medical students from all the semesters. A predesigned questionnaire was used to evaluate the knowledge, attitude and practices of the respondents. The response options were ‘yes’ or ‘no’ for some questions, and a 5 point Likert scale used to assess some questions. The data was analyzed using MS office Excel.Results: A total of 457 fully completed questionnaires from the respondents were evaluated. Majority of the respondents (70%) were females, and 91% of the respondents were aware of antibiotic resistance as a global problem. On analysis of score of questions assessing knowledge, 91% of respondents had attained a score in the range of 5-7. Majority (83%) of the respondents used antibiotics only on doctor’s prescription and 74% of the respondents had completed the prescribed course.Conclusions: The present study gives an insight on the knowledge, attitude and practices of medical students on antibiotic use, and can be used as a tool to plan educational strategies to improve the knowledge of the students regarding rational use of antibiotics

Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis

BACKGROUND: Neurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome. METHODS: We conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models. RESULTS: We included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67-82]), than encephalopathy (54% [42-65]). Intensive care use was high (38% [35-41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27-32]. The hazard of death was comparatively lower for patients in the WHO European region. INTERPRETATION: Neurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different risk factors for encephalopathy and stroke suggest different disease mechanisms which may be amenable to intervention, especially in those who develop neurological symptoms after hospital admission

Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis

Background Neurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome. Methods We conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models. Results We included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67–82]), than encephalopathy (54% [42–65]). Intensive care use was high (38% [35–41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27–32]. The hazard of death was comparatively lower for patients in the WHO European region. Interpretation Neurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different risk factors for encephalopathy and stroke suggest different disease mechanisms which may be amenable to intervention, especially in those who develop neurological symptoms after hospital admission

Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis.

BackgroundNeurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome.MethodsWe conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models.ResultsWe included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67-82]), than encephalopathy (54% [42-65]). Intensive care use was high (38% [35-41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27-32]. The hazard of death was comparatively lower for patients in the WHO European region.InterpretationNeurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different risk factors for encephalopathy and stroke suggest different disease mechanisms which may be amenable to intervention, especially in those who develop neurological symptoms after hospital admission

Limitations of intrauterine balloon catheters for ova collection in sheep

Attempts were made to collect ova from superovulated ewes by surgically fitting a balloon catheter in each uterine lumen either during the luteal phase or follicular phase of their oestrous cycle. A total of six ovulations and 37 unovulated follicles were observed and one unfertilized, degenerating ovum was collected from the six catheterised ewes. This was significantly different (P < 0.01) from the 22 ovulations and eight unovulated follicles observed and the 14 ova recovered from the three control ewes. The presence of catheters prevented plasma LH peak during the oestrus following catheterisation, and as a result, ovulation failed as evidenced by the low plasma progesterone levels from that oestrus throughout the experiment. No pathogenic micro-organisms were isolated from the uteri of any of the ewes. However, histological studies showed infiltration of lymphocytes and monocytes in the endometrium of the catheterised ewes but not in the controls, indicating an immunological type of reaction to the presence of the catheters

PREPARATION OF TEASER BULLS BY DORSAL SCROTAL PENILE DEFLECTION

SUMMARY A simple, quick and reliable technique of preparing teaser bulls has been developed. Four Bos indicus bulls aged between 1 year 6 months and 2 years were subjected to this method by deflecting their penes backwards about 2 to 3 cm posterior and dorsal to the attachment of the scrotum. No serious postoperative complications were recorded. The sexual behaviour and libido of the bulls did not change after subjecting them to this technique. Copyrigh

Estrus synchronization and fertility after the control of formation and regression of the corpus luteum, and emergence of the ovarian dominant follicle in cattle

Three expirements were conducted with the aim of improving estrus synchronization and conception rates to AJ after progestogen-based estrus synchronization. In Experiment 1, stage of the estrous cycle was synchronized in heifers, and on Day 6 of the ensuing cycle (Day 0 of treatment) heifers (n=14) received a norgestomet implant, with prostaglandin (PG) administered on Days 0 and 1. This resulted in an increase in pulsatile secretion of LH and continued growth of the dominant follicle. On Day 4, groups of heifers received 500 (n=4), 1,000 (n=4), 1,500 (n=3) or 3,000 (n=3) IU hCG, which induced the dominant follicle to ovulate. This was followed within 48 h by the emergence of a newly-recruited dominant follicle that ovulated after the removal of norgestomet and injection of PG on Day 10. The dose of 500 IU hCG was sufficient to ovulate the dominat follicle on Day 4, and this dose was used in subsequent experiments. In Experiment 2, stage of the estrous cycle was synchronized in cows, and on Day 6 of the ensuing cycle (Day 0 of treatment) the cows were given PG and a single norgestomet implant. On Day 4 of treatment, cows were divided into 2 groups: Group 2A (n=17), injection of PG; Group 2B (n=13), injection of PG plus 500 IU hCG. Norgestomet implants were removed on Day 10, coinciding with an additional injection of PG. Cows were inseminated 12 h after estrus. Cows that received hCG (ovulated a newly- recruited dominant follicle) had a higher (