Knowledge, attitude and practices of antibiotic usage and resistance among the second year MBBS Students

Background: Social aspect of antibiotic management forms a significant way to overcome the rapidly intensifying problem of antibiotic resistance. Knowledge helps in spreading awareness and understanding while attitude and practices influences health related behaviour. Medical students should not only be made aware of the current emerging health issues but also be directed towards rational antibiotics prescribing behaviour as future medical practitioners. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices (KAP) related to antibiotic usage and resistance among second year (fourth semester) MBBS students.Methods: This was a cross-sectional, questionnaire based study conducted in department of pharmacology of a government medical college in Kerala, India. Questionnaire was distributed among a batch of 120 second year MBBS students after one of the pharmacology lecture session. Attitude and Practices related questions were assessed using Likert scale. Data was entered in excel and analysed using descriptive statistics of SPSS to generate frequency and percentage.Results: 91.6% (110) were considered valid for analysis. Mean age was 21±1 years. Students had fair knowledge regarding antibiotics usage and resistance with mean correct response 79.72±25.37%. Mean correct responses of attitude and practices related questions were found to be 55.95±25.63% and 64±13.79% respectively.Conclusions: Most of the students were aware of the antibiotic resistance and its consequences. However, their attitude and practices were found to be a matter of great concern. An educational intervention can be introduced to bring about behaviour changes regarding rational antibiotics prescribing among them

Concept learning through question framing in Pharmacology

Background: Framing questions is a skill that requires expertise, knowledge, guidance and mentoring. It provides structure for deep learning, critical thinking and also promotes interaction and communication. Objective of this study is to analyze the question framing skills of fifth semester medical students on a ‘must know’ area in Pharmacology.Methods: A cross-sectional study was done in the Department of Pharmacology of a Government Medical College in Central Kerala. After briefing about the study, each of the participants was instructed to frame a question which were collected after 15 minutes. The data on different aspects of questions was analysed by Statistical Package for the Social Sciences 16.Results: Total 130 students, 79 females and 51 males participated in this study. 7 questions were incomplete and excluded from further analysis. From the rest 123 properly framed questions, 106(86.2%) were correct, 10(8.1%) were partially correct and 7(5.7%) incorrect with regards to the task assigned. In this study knowledge as well as application was tested in 50.4% questions, comprehension in 21.1% and application alone in 22.8%. The knowledge dimension tested was factual in 91(74%) and conceptual in 32(26%). Non-hierarchical classification showed 96(78%) convergent and 27(22%) divergent.Conclusions: In this study majority of the participants framed direct short answer questions which reflects factual knowledge indicating their lower-level cognition. Critical thinking and procurement of higher level cognition can be attained by directing them to frame the right question especially in medical education

Diuretic activity of ethanolic extract of whole plant of Sphaeranthus indicus linn in albino rats

Background: Sphaeranthus indicus Linn (S. indicus Linn) is a medicinal plant widely used in Indian traditional system of medicine for treating various ailments. The aim of the study was to evaluate diuretic activity by Lipschitz method in albino rats.Methods: Thirty albino rats were grouped into five groups and each contained six rats. Group I (control group) received 25ml/kg each of 0.9% sodium chloride orally. Group II (standard) received Hydrochlorothiazide 25 mg/kg orally dissolved in isotonic normal saline. Groups III, IV and V received ethanolic extracts of S. indicus Linn in doses 100mg/kg, 200mg/kg and 300mg/kg respectively dissolved in isotonic saline orally. The mice were put in metabolic cages and urine samples were collected for all the groups up to 24 hours after dosing. Urine was analysed for volume, urinary excretion ratio, diuretic activity, sodium and potassium composition electrolytes. Data was analysed using SPSS version 16 for windows.Results: Single dose administration of S. indicus in doses of 100, 200 and 300 mg/Kg as compared to Hydrochlorothiazide (25 mg/kg)have significantly (p<0.001, ANOVA) increased total urine output along with an increase in concentration of sodium and potassium. S. indicus Linn 300 mg/Kg produced greater diuretic activity, which is comparable to the effect of standard.Conclusions: The extract treated rats showed a dose dependent increase in urine volume. Maximum diuretic and kaliuretic activity were observed at the dose of 300 mg/kg of the extract. The present study supports and confirms the basis for folklore use of S. indicus Linn as a diuretic agent

Knowledge, attitude and practices of antibiotic usage and resistance among the second year MBBS Students

Background: Social aspect of antibiotic management forms a significant way to overcome the rapidly intensifying problem of antibiotic resistance. Knowledge helps in spreading awareness and understanding while attitude and practices influences health related behaviour. Medical students should not only be made aware of the current emerging health issues but also be directed towards rational antibiotics prescribing behaviour as future medical practitioners. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices (KAP) related to antibiotic usage and resistance among second year (fourth semester) MBBS students.Methods: This was a cross-sectional, questionnaire based study conducted in department of pharmacology of a government medical college in Kerala, India. Questionnaire was distributed among a batch of 120 second year MBBS students after one of the pharmacology lecture session. Attitude and Practices related questions were assessed using Likert scale. Data was entered in excel and analysed using descriptive statistics of SPSS to generate frequency and percentage.Results: 91.6% (110) were considered valid for analysis. Mean age was 21±1 years. Students had fair knowledge regarding antibiotics usage and resistance with mean correct response 79.72±25.37%. Mean correct responses of attitude and practices related questions were found to be 55.95±25.63% and 64±13.79% respectively.Conclusions: Most of the students were aware of the antibiotic resistance and its consequences. However, their attitude and practices were found to be a matter of great concern. An educational intervention can be introduced to bring about behaviour changes regarding rational antibiotics prescribing among them

Self-Medication Practices among First and Second Year Medical Undergraduates

Objective:&nbsp;The objectives of our study were to estimate prevalence of self medication, to assess knowledge, attitude, and practice (KAP) of self medication and to compare the risk factors of self medication practices amongst first and second year medical undergraduates, of a Government Medical College in Kerala, India. Methods:&nbsp;A questionnaire-based cross-sectional study was conducted among medical students after obtaining Institutional Ethics Committee approval and informed consent. A pre-validated questionnaires was used to collect data. Descriptive and analaytical statistics were performed and variables associated with self-medication were entered into multivariate logistic regression analysis to compute adjusted odds ratio (OR) and 95% confidence intervals (95% CI). Results:&nbsp;The response rate was 59.47% (233/375). &nbsp;More than three quarters of the participants responded correctly to the query on “what an over-the-counter drug is”. As compared to 46.8% of first years, 67.6% of second years had practiced self-medication in the past 6 months. The most common medical condition/symptom for consuming self-medication was for managing common cold and paracetamol was the most common medication. Risk of developing adverse drug reaction was considered as a serious threat after self-medication by around three quarters of the participants. There was a significant association of self-medication practice among the second years as compared to first years(p=0.009,OR-1.64(95% CI 1.16-2.31). Conclusion: Prevalence of self-medication was high among medical students and there was a greater risk &nbsp;of self-medication among the second years (1.64 times) as compared to the first year students. Study showed that the students had poor knowledge of adequate self-medication , positive attitude towards self-medication and common but inadequate &nbsp;practice. Knowledge of medicines obtained for similar previous illness and the feeling that there is no need to consult doctor for minor ailments were the main reasons for self medication

Comparative study of the toxicity of 5-fluorouracil-adriamycin-cyclophosphamide versus adriamycin-cyclophosphamide followed by paclitaxel in carcinoma breast

Context: When cure is possible treatment should be undertaken despite life-threatening toxicities. Fluorouracil-Adriamycin-Cyclophosphamide (FAC) and Adriamycin-Cyclophosphamide (AC-P) are two popular regimens used in the treatment of carcinoma breast and the data regarding the toxicity profile of the AC-P regimen is scarce in the South Indian population. Aims: To study the severity of different types of toxicities seen in patients on FAC and AC-P regimens, to grade the toxicity according to the World Health Organization (WHO) toxicity grading, and to compare the same. Settings and Design: A prospective observational study, with 50 patients in each regimen, was conducted in the Department of Radiotherapy between February 2007 and July 2008. Materials and Methods: The high risk patients received the AC-P regimen and the rest received the FAC regimen. The toxicities developed were graded according to the WHO guidelines. Statistical Analysis Used: The data was analyzed using the chi square test in SPSS 16. Results: Anemia, hyperpigmentation, stomatitis, and diarrhea were significantly high (P &lt; 0.05) in patients receiving the FAC regimen, whereas, leukopenia, myalgia, arthralgia and peripheral neuropathy were significantly high (P &lt;0.05) in patients receiving the AC-P regimen. The Karnofsky performance status was higher in patients receiving the AC-P regimen. Conclusions: Although both the regimens had different toxicity profiles the quality of life was better for patients on the AC-P regimen

Comparative study of the toxicity of 5-fluorouracil-adriamycin-cyclophosphamide versus adriamycin-cyclophosphamide followed by paclitaxel in carcinoma breast

Context: When cure is possible treatment should be undertaken despite life-threatening toxicities. Fluorouracil-Adriamycin-Cyclophosphamide (FAC) and Adriamycin-Cyclophosphamide (AC-P) are two popular regimens used in the treatment of carcinoma breast and the data regarding the toxicity profile of the AC-P regimen is scarce in the South Indian population. Aims: To study the severity of different types of toxicities seen in patients on FAC and AC-P regimens, to grade the toxicity according to the World Health Organization (WHO) toxicity grading, and to compare the same. Settings and Design: A prospective observational study, with 50 patients in each regimen, was conducted in the Department of Radiotherapy between February 2007 and July 2008. Materials and Methods: The high risk patients received the AC-P regimen and the rest received the FAC regimen. The toxicities developed were graded according to the WHO guidelines. Statistical Analysis Used: The data was analyzed using the chi square test in SPSS 16. Results: Anemia, hyperpigmentation, stomatitis, and diarrhea were significantly high (P < 0.05) in patients receiving the FAC regimen, whereas, leukopenia, myalgia, arthralgia and peripheral neuropathy were significantly high (P <0.05) in patients receiving the AC-P regimen. The Karnofsky performance status was higher in patients receiving the AC-P regimen. Conclusions: Although both the regimens had different toxicity profiles the quality of life was better for patients on the AC-P regimen