Primary dysmenorrhea: evaluation and treatment pattern among female medical students

Background: Dysmenorrhea is a very common condition in females in fertile age group and its affective and somatic features often limit female mobility which results in loss of work hours. The aim of the study was to evaluate prevalence, severity, drug usage and loss of work days among young female medical students.Methods: The current questionnaire based study was done in Department of pharmacology, GMC Jammu over a period of 3 months. Female students aged between 17-24 years who consented for participation were included. The demographic profile and detailed history of dysmenorrhea was recorded.Results: Out of 342 participants, 218 females (63.7%) had history of dysmenorrhea. Most of the dysmenorrhic females had menarche between 13-14 yrs of age (73.3%) and menstrual cycle of 21-34 days (82.5%), duration of bleeding less than 6 days (91.6%) and had a positive family history of dysmenorrhea (58.7%). Majority of females had mild to moderate features of dysmenorrhea (93.4%). Most common medication was Mefenemic acid alone and in combination (90.5%). Most of the females took self-medication (69.8%) and only 30.2% took medicines on advice of doctor. 71.5% students missed their classes due to symptoms of dysmennorhea.Conclusions: Dysmenorrhea is quite prevalent among college going medical students. Most of them had positive family history. Mefenemic acid and its combination was frequently used to treat symptoms. On an average 1-2days were lost due to dysmenorrhea

KAP on antibiotic usage and resistance among second professional medical students

Background: Antibiotics are wonder drugs as they prevent and treat bacterial infections. However, their irrational use even by wrong prescribing behaviour of physician leads to antibiotic resistance medical students are future doctors and are provided knowledge and practice of antibiotics in treatment, and prevention of diseases in their study curriculum of second professional course mainly in chapters of pharmacology and microbiology. Therefore, the present study was to determine the second-year medical students’ knowledge, attitude and perception regarding antimicrobial use and resistance.Methods: Study was conducted on second professional undergraduate medical students from Government Medical College, Jammu. 140 students participated, and informed consent was taken prior to study. A validated questionnaire comprised of 20 questions was provided to them and responses were recorded. Questionnaire was comprised of 20 questions (13 questions attributed to knowledge of antibiotics usage and resistance, six to attitude and one question regarding perception).Results: The students showed fair knowledge about antibiotics and resistance. Percentages of fully correct answers was between 63-100% regarding knowledge of antibiotics. The attitude results revealed that self-medication by the student was observed in 67%, while 70% agreed that they had left over antibiotics at home, but only 42% committed that they take these left over antibiotics. As far as practice was concerned the maximum students consult text books as source of knowledge regarding resistance followed by Wikipedia.Conclusions: The current study observed high score of knowledge than attitude in medical students regarding antibiotic usage and resistance and increasing influence of internet like Wikipedia. This underscores the need for more effort in updating the students regarding antibiotic usage and resistance and laying more emphasis in the core curriculum of their academics

CHSI costing study-Challenges and solutions for cost data collection in private hospitals in India

INTRODUCTION: Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB PM-JAY) has enabled the Government of India to become a strategic purchaser of health care services from private providers. To generate base cost evidence for evidence-based policymaking the Costing of Health Services in India (CHSI) study was commissioned in 2018 for the price setting of health benefit packages. This paper reports the findings of a process evaluation of the cost data collection in the private hospitals. METHODS: The process evaluation of health system costing in private hospitals was an exploratory survey with mixed methods (quantitative and qualitative). We used three approaches-an online survey using a semi-structured questionnaire, in-depth interviews, and a review of monitoring data. The process of data collection was assessed in terms of time taken for different aspects, resources used, level and nature of difficulty encountered, challenges and solutions. RESULTS: The mean time taken for data collection in a private hospital was 9.31 (± 1.0) person months including time for obtaining permissions, actual data collection and entry, and addressing queries for data completeness and quality. The longest time was taken to collect data on human resources (30%), while it took the least time for collecting information on building and space (5%). On a scale of 1 (lowest) to 10 (highest) difficulty levels, the data on human resources was the most difficult to collect. This included data on salaries (8), time allocation (5.5) and leaves (5). DISCUSSION: Cost data from private hospitals is crucial for mixed health systems. Developing formal mechanisms of cost accounting data and data sharing as pre-requisites for empanelment under a national insurance scheme can significantly ease the process of cost data collection

Monitoring of incidence, severity, and causality of adverse drug reactions in hospitalized patients with cardiovascular disease

Background : Patients admitted to cardiology department are mostly on polypharmacy. So drug-drug interactions and adverse effects of drugs are quite common. Yet, there is a paucity of data regarding adverse drug reaction (ADR) monitoring in cardiology department in India. The present study is an effort to fill up these lacunae. Materials and Methods : A prospective, observational study registering 966 indoor cardiology patients according to predetermined inclusion and exclusion criteria was conducted for one year. ADR profile was noted by spontaneous reporting and intensive monitoring. Naranjo ADR probability scale was used to establish the causality. Results : A total of 208 ADRs were reported from 188 patients (19.5%). Of these 188 patients, 62 patients (33%) were hospitalized primarily due to the development of ADRs, while 126 (67%) patients developed ADRs during hospital stay. Nitrates were the most common offender drug group (17.8%). Conclusion : Development of ADR in one of every five cardiac patient points toward a grave situation, but a higher incidence of Type A reactions in cardiology department means that these can be avoided

CHSI costing study–Challenges and solutions for cost data collection in private hospitals in India. S1 File

Data collected part of a study to investigate the cost of health services in 21 private hospitals, located in 7 states of India (Andhra Pradesh, Bihar, Gujarat, Odisha, Rajasthan, Uttar Pradesh, and West Bengal)

Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes.

BACKGROUND: In low- and middle-income countries (LMICs), provisioning for surgical care is a public health priority. Ayushman Bharat Pradhan Mantri-Jan Aarogya Yojana (AB PM-JAY) is India's largest national insurance scheme providing free surgical and medical care. In this paper, we present the costs of surgical health benefit packages (HBPs) for secondary care in public district hospitals. METHODS: The costs were estimated using mixed (top-down and bottom-up) micro-costing methods. In phase II of the Costing of Health Services in India (CHSI) study, data were collected from a sample of 27 district hospitals from nine states of India. The district hospitals were selected using stratified random sampling based on the district's composite development score. We estimated unit costs for individual services-outpatient (OP) visit, per bed-day in inpatient (IP) and intensive care unit (ICU) stays, and surgical procedures. Together, this was used to estimate the cost of 250 AB PM-JAY HBPs. RESULTS: At the current level of utilization, the mean cost per OP consultation varied from US$4.10 to US$2.60 among different surgical specialities. The mean unit cost per IP bed-day ranged from US$13.40 to US$35.60. For the ICU, the mean unit cost per bed-day was US$74. Further, the unit cost of HBPs varied from US$564 for bone tumour excision to US$49 for lid tear repair. CONCLUSIONS: Data on the cost of delivering surgical care at the level of district hospitals is of critical value for evidence-based policymaking, price-setting for surgical care and planning to strengthen the availability of high quality and cost-effective surgical care in district hospitals