Final year medical students versus interns: information seeking behaviour about COVID-19 therapy in India

Background: Doctors alone must be capable of taking ultimate responsibilities for making decisions in clinical uncertainties. A right clinical judgement and management was the ultimate priority for health care workers during the COVID-19 pandemic. The objective of our study was to access knowledge about COVID-19 treatment among the final year bachelor of medicine and bachelor of surgery (MBBS) students and interns and thereby to understand the information seeking behaviour.Methods: Multicentric cross-sectional questionnaire-based study among the final year MBBS students and interns. The google form questionnaire was sent to the participants through whatsapp or mail. The questions were related to the drugs, the precautionary measures and the dead body disposal in COVID-19. Attitude regarding seeking information about the new disease, updated treatment guidelines as well as the preferred resource materials was also studied. The sample size was calculated based on a pilot study.Results: Out of 316 participants, 30.7% had good, 53.2% had adequate and 16.1% had inadequate knowledge regarding the updated treatment guidelines.  In one of the questions about hydroxychloroquine, 51.5% final year MBBS students (n=200) and 63.8% interns (n=116) responded correctly (p<0.034). 65.4% gathered information by self-directed learning through various sources. 45.8% gathered information from social media while 44.4% read printed materials and 39.3% heard online/offline lectures.Conclusions: We conclude that the final year MBBS students and interns have satisfactory knowledge about COVID-19 treatment. Interns had better awareness than the final year MBBS students. Retaining the theoretical knowledge during internship will make the young doctors more confident while practicing

Comparing the antiepileptic effects of atorvastatin, celecoxib, ashwagandha, clove oil, and Sodium valproate on chemo-shock induced seizures in male Wistar albino rats

Background: Antiepileptic potential of statins, COX inhibitors and other herbal medications are to be evaluated in experimental animals so that the most efficacious can be translated for human use as an adjunct to the commonly used anti-epileptic drugs. Methods: This experimental animal study grouped 30 male Wistar albino rats into 6 groups with each containing 5 rats of which one group was control, one was the standard drug and the other 4 were treatment groups which received Atorvastatin, Celecoxib, Ashwagandha and Clove oil. These drugs were administered 30 minutes prior to administering Pentylene-tetrazole which induced convulsions and the various seizure parameters were analysed. The blood samples of the animals were also assessed for anti-oxidant activity by measuring superoxide dismutase and catalase levels in the blood. Results: The onset of seizure was significantly delayed by Ashwagandha (2.55±0.94), similar to the latency shown by the standard drug (2.09±1.21). The duration of convulsions was very significantly reduced in all the 5 drug groups in comparison to the control (p&lt;0.001). The clonic jerk duration was not reduced as effectively as the standard drug. The duration of recovery time amongst the various groups was also significant (p&lt;0.05). The SOD and Catalase levels of no groups showed any possible association between the anti-epileptic efficacy of these drugs and the anti-oxidant enzyme levels. Conclusions: Ashwagandha has good anti-epileptic efficacy not less than the standard drug when the various drug groups were compared

Theory Content, Question-Behavior Effects, or Form of Delivery Effects for Intention to Become an Organ Donor? Two Randomized Trials

Eliciting different attitudes with survey questionnaires may impact on intention to donate organs. Previous research used varying numbers of questionnaire items, or different modes of intervention delivery, when comparing groups. We aimed to determine whether intention to donate organs differed among groups exposed to different theoretical content, but similar questionnaire length, in different countries. We tested the effect of excluding affective attitudinal items on intention to donate, using constant item numbers in two modes of intervention delivery. Study 1: A multi-country, interviewer-led, cross-sectional randomized trial recruited 1007 participants, who completed questionnaires as per group assignment: including all affective attitude items, affective attitude items replaced, negatively-worded affective attitude items replaced. Study 2 recruited a UK-representative, cross-sectional sample of 616 participants using an online methodology, randomly assigned to the same conditions. Multilevel models assessed effects of group membership on outcomes: intention to donate (primary), taking a donor card, following a web-link (secondary). In study 1, intention to donate did not differ among groups. Study 2 found a small, significantly higher intention to donate in the negatively-worded affective attitudes replaced group. Combining data yielded no group differences. No differences were seen for secondary outcomes. Ancillary analyses suggest significant interviewer effects. Contrary to previous research, theoretical content may be less relevant than number or valence of questionnaire items, or form of intervention delivery, for increasing intention to donate organs

Financial benefit of antidiabetic drugs available at jan aushadhi (people's drug) stores to geriatric pensioners: A pilot study from India

Background: For the elderly, affected with Type II diabetes the costs for medications can be immense and forms a substantial part of their savings and pensions. Aims and Objectives: Diabetes mellitus is a major health issue in India and the treatment costs severely affect the elderly who are dependent on their family or on their pensions. In this study, we evaluated the economic cost of branded versus Jan Aushadhi drugs for geriatric pensioners. Materials and Methods: This was an observational, cross-sectional study and was conducted at the outpatient department of General medicine and Endocrinology at Amrita Institute of Medical Sciences, Ernakulam, Kerala, India. The prescriptions of patients attending the clinic for the care of type II diabetes and associated co-morbidities were analysed. The age, sex, and the number of medications were noted. The price of the costliest, cheapest, and most prescribed branded drugs were noted from the CIMS index 2020, while that for Jan Aushadhi drug was observed from the price catalogue. The financial cost burden on retired aged citizens was calculated by considering INR 8000 as the pension amount. Results: The average cost of the drugs when bought from the costliest brands amounted to 2592.52, of which 750.31 amounted for antidiabetics, while when purchased from Jan Aushadhi was 542.3 and 350.46, respectively. The percentages of the cost required for monthly treatment for an individual with 8000 INR pension for the branded drug was 32.4% and 6.77% for all medications and antidiabetic drugs, while when bought from Jan Aushadhi was 9.37 and 4.38, respectively. Conclusions: A significant difference between cost for Jan Aushadhi and branded drugs and this can be of benefit to the geriatric pensioners. As far as the authors are aware of this is the first study that addresses the beneficial effect of Jan Aushadhi antidiabetic drugs in the geriatric pensioners and has high relevance and use in public health

Clinical Evaluation of Mother Tincture as an Antihypertensive

Viscum album , an infrequently used antihypertensive in homeopathy, is evaluated by 1-group pretest–posttest model in primary hypertension. The drug was administered for 12 weeks at a dosage of 10 drops 3 times a day. Using paired t test, a significant drop in blood pressure ( P < .0001) and serum triglyceride ( P < .0001) was observed in the treatment group. This dual effect of Viscum album shows promise in optimizing therapy for primary hypertension

Sandalwood Oil and Turmeric-Based Cream Prevents Ionizing Radiation-Induced Dermatitis in Breast Cancer Patients: Clinical Study

Background: The primary objective of this study was to ascertain the benefit of Vicco turmeric Ayurvedic cream (VTC; Vicco Laboratories, Mumbai, India) sandalwood oil and turmeric-based cream in preventing radiodermatitis in women undergoing curative radiotherapy for their breast cancer. Methods and Materials: The study was an investigator-blinded randomized study with Johnsons Baby Oil (JBO; Johnson &amp; Johnson Ltd., Baddi, India) as a comparator, administered daily from the start of radiation therapy for 5 weeks in women receiving breast radiation therapy, 50 Gy in 2 Gy fractions daily for 5 weeks. The endpoints were to ascertain the delay in the appearance and the degree of severity of dermatitis throughout the study period in accordance to the Therapy Oncology Group (RTOG) score. Results: The results indicated that the topical application of VTC delayed and mitigated the radiodermatitis. When compared to the Johnson’s Baby Oil, a significant decrease (p = 0.025) in the incidence of grade 1 was seen at week two, and also in grade 2 and 3 at week 3 (p = 0.003) and week 4 (p = 0.02), respectively, in the VTC cohort. A concomitant decrease in the average severity was also observed at week 2 (p = 0.02), week 3 (p = 0.05) and week 4 (p = 0.03). Conclusions: The results indicate that VTC cream significantly reduces radiation dermatitis when applied to the breast during and after radiation therapy. The result of this study indicates the beneficial effects. Double blind randomized control studies are required to further confirm the beneficial effects of VTC in mitigating radiodermatitis is people undergoing radiation treatment for their cancer

Honey Mitigates Radiation-Induced Oral Mucositis in Head and Neck Cancer Patients without Affecting the Tumor Response

Radiation-induced mucositis is a dose-limiting factor in the effective treatment of head and neck (H &amp; N) cancers. The objective of this study was to understand the efficacy of honey in mitigating radiation-induced mucositis and whether it would interfere with tumor control. This was a single-blinded, randomized, controlled study and was carried out in patients with H &amp; N cancer requiring curative radiotherapy (&gt;62 Gy (Gray)). The patients meeting the inclusion criteria were randomly assigned to receive either honey (n = 25) or povidone-iodine (active comparator) (n = 25) during radiotherapy. Oral mucositis was assessed using the RTOG (Radiation Therapy Oncology Group) grading system before the start, during, and at the end of the treatment by an investigator unaware of the treatment. The results indicate that when compared with the active comparator, honey reduced the radiation-induced oral mucositis, decreased the incidence of intolerable mucositis, treatment breaks, loss of treatment days (p &lt; 0.0001 and &lt; 0.0003) and did not affect the radiation-induced tumor response. The clinical observations indicate that honey mitigates the radiation-induced mucositis and does not interfere with tumor cell killing