Self-medication of sleeping pills among MBBS students in a medical college of West Bengal, India

Background: Psychological stress, anxiety, depression and sleep disturbance are highly prevalent in medical students and therefore they are at higher risk of using sleeping pills defined as any pharmaceutical preparation inducing sleep. There is currently paucity in data describing the prevalence of sleeping pill use among medical students in India.Objective: To evaluate the prevalence of sleeping pill use among medical students in Burdwan Medical College (BMC).Methods: A cross sectional study was done by anonymous questionnaires from MBBS students enrolled at BMC. Questionnaire consisted of social and demographic variable and use of sleeping pills, tobacco and alcohol since enrollment. Collected data were analyzed by Athen's insomnia scale and DASS-21.Results: With response rate72.2% (397 out of 550) and of 397 respondants (1st yr-97+2nd yr-90+3rd yr part I-114+3rd yr part II-96), 6.3% reported use of sleeping pill at some time since enrollment. Athen's insomnia scales showed 27% poor sleepers. According to DASS-21, 44% respondents were depressive, 61.96% anxious, and 31.73% stressed. Insomnia were found to significantly (p value <0.0001) associated with sleeping pill use. Majority (96%) of sleeping pill uses were self-medicated.Conclusions: Tendency to use sleeping pill is very less (majority self-medicated), though a substantial proportion of medical undergraduate students were found to be depressed, anxious, stressed revealing a neglected area of students' psychology requiring urgent attention

Rationality of utilization of antimicrobial agents in medical intensive care unit of a tertiary care hospital

Background: Patients admitted to intensive care unit receive multiple medications of different pharmacological classes due to various life threatening ailments. This study was conducted to assess the patterns of usage of antimicrobial agents in medical ICU of a tertiary care hospital and to suggest necessary modifications in prescribing patterns to achieve rational therapeutic practices.Methods: A cross-sectional observational study was carried out at ICU of the tertiary care hospital for 6 months. From the inpatient case record of ICU relevant data on prescription of each patient was collected. The demographic status, disease data and the utilization of different antimicrobial drug classes and individual drugs were analysed.Results: Of 753 patients admitted in the medical ICU during the study period, 640 consecutive patients were included for analysis. Male to female ratio was 1.45. Mean age was 63.32±17.93 years. Extensive poly-pharmacy (100%) and drugs with non-generic name (73%) noticed among the prescriptions.Average number of drugs per prescription was 12.1±2.13. Penicillins (51.87%) and cephalosporins (45.78%) were most commonly used antimicrobial drug classes. Piperacillin (37.03%), ceftriaxone (33.28%) and levofloxacin (22.5%) were commonly used antimicrobial drugs. A total of 181 prescriptions contained two and 138 contained three antimicrobial drugs. Piperacillin+tazobactam(37.03%) was the most common fixed dose combination noticed.Conclusions: Overall extensive poly-pharmacy and drugs with non-generic name noticed among the prescriptions. Few interventional programs should be aimed at control of infections, rational antimicrobial drug prescription to minimize adverse drug events, emergence of bacterial resistance and attenuating unnecessary cost

Evaluation of pharmacology teaching-learning methods in a government medical college

Background: Pharmacology is a major subject in medical science and always changing, so according to it pharmacologists also need to reform their teaching method. Students’ opinion in this evaluation of teaching is a good option.Methods: A questionnaire based study was conducted in Burdwan Medical College on 230 students of two batches.Results: One forty eight students thought that the subject was interesting. Twenty eight percent students opined that Pharmacology class was not interesting. Students found interest mostly in prescription writing, drug interaction and therapeutic problems in practical section. Though 53.4% found pharmacy was less interest. They suggested some reforms in teaching, 61.3% voted for introduction of audio-visual aid and 74.3% response on clinical demonstration in hospital ward. According to 82.6% students, there should be more problem solving exercise during teaching pharmacology; giving hand-out before everyday class, class in clinical setting and more emphasis on clinical pharmacology were also needed. MCQ exam only (31%) and written viva both (51%) were good ways of evaluation according to them.Conclusions: This study helps in knowing students’ opinion and preferences in curriculum to make it more interesting and aids to modify the undergraduate Pharmacology teaching pattern

Rationality of utilization of antimicrobial agents in medical intensive care unit of a tertiary care hospital

Background: Patients admitted to intensive care unit receive multiple medications of different pharmacological classes due to various life threatening ailments. This study was conducted to assess the patterns of usage of antimicrobial agents in medical ICU of a tertiary care hospital and to suggest necessary modifications in prescribing patterns to achieve rational therapeutic practices.Methods: A cross-sectional observational study was carried out at ICU of the tertiary care hospital for 6 months. From the inpatient case record of ICU relevant data on prescription of each patient was collected. The demographic status, disease data and the utilization of different antimicrobial drug classes and individual drugs were analysed.Results: Of 753 patients admitted in the medical ICU during the study period, 640 consecutive patients were included for analysis. Male to female ratio was 1.45. Mean age was 63.32±17.93 years. Extensive poly-pharmacy (100%) and drugs with non-generic name (73%) noticed among the prescriptions.Average number of drugs per prescription was 12.1±2.13. Penicillins (51.87%) and cephalosporins (45.78%) were most commonly used antimicrobial drug classes. Piperacillin (37.03%), ceftriaxone (33.28%) and levofloxacin (22.5%) were commonly used antimicrobial drugs. A total of 181 prescriptions contained two and 138 contained three antimicrobial drugs. Piperacillin+tazobactam(37.03%) was the most common fixed dose combination noticed.Conclusions: Overall extensive poly-pharmacy and drugs with non-generic name noticed among the prescriptions. Few interventional programs should be aimed at control of infections, rational antimicrobial drug prescription to minimize adverse drug events, emergence of bacterial resistance and attenuating unnecessary cost

Antimicrobial Prophylaxis in Lower Uterine Segment Caesarean Section: A Prospective Observational Data-based Study

Introduction: Any major surgery like lower uterine Caesarean Section (CS) can be hazardous due to postoperative nosocomial infection. Pregnant mothers are at greater risk during such surgical intervention as compared to vaginal delivery. Prophylactic antibiotic administration is a standard practice across the globe to prevent such anticipated postoperative infection. Aim: To evaluate the prophylactic antimicrobial use with regards to the choice of antimicrobials, dose, route, timing and duration, any possible Adverse Drug Reaction (ADR) as well as to assess the frequency of the postoperative morbidity due to infection (if any). Materials and Methods: A prospective observational data-based study was conducted in the Department of Pharmacology in collaboration with Department of Obstetrics and Gynaecology, Burdwan Medical College and Hospital, Burdwan, West Bengal, India, from February 2016 to October 2017. Study was conducted on 1944 pregnant women of reproductive age group planned or scheduled for elective/emergency lower segment CS, but otherwise healthy and received prophylactic antimicrobials for the surgery. They were prospectively observed regarding the treatment they received with focus on antimicrobial agents from the period of antimicrobial prophylaxis during their stay at hospital to till their discharge. Demographic data, vital signs, indication of CS, postoperative infections and ADR if any were recorded in predesigned proforma. The study population was divided into two groups: group A included 995 mothers, who received ceftriaxone sodium (1 g intravenously) and metronidazole (15 mg/kg) infusion and group B included 949 mothers, who received ampicillin (2 g intravenously), metronidazole (15 mg/kg) infusion and injection gentamycin (5 mg/kg) for 0.5 hour before initiation of CS. The data were statistically analysed by standard statistical software Microsoft Excel 2010 and Statistical Package for the Social Sciences (SPSS) sotware version 27.0 (SPSS Inc., Chicago, IL, USA) expressed as mean and standard deviation and percentage. Independent t- test and Chi-square test were used for analysis. Results: The mean age of group A was 22.36±3.07 years and group B was 22.76±2.47 years. Endomyometritis was documented in 4 (0.4%) from group A and 2 (0.21%) from the group B. Wound infection was present in 3 (0.3%) for group A and five (0.5%) for the group B. Infection related complications like chest infection seen in 7 (0.7%) for group A and in 3 (0.31%) for group B and urinary tract infection was noticed in 6 (0.6%) for group A and 5 (0.52%) for group B. Any incidence of maternal mortality was not evident among the two study groups and statistically insignificant ADR like vomiting and maculopapular rash (p-value=0.324) was observed in both the study groups with the use of above-mentioned antimicrobial therapy. Conclusion: Prophylactic use of ceftriaxone plus metronidazole and combination of triple antimicrobial therapy of ampicillin, metronidazole, and gentamycin therapy at the usual standard dose were commonly used antimicrobials at the present set up and they are safe and equally effective in decreasing considerably the incidence of post caesarean maternal infection thereby reducing their morbidity and mortality

Failure and deformation mechanisms at macro- and nano-scales of alkali activated clay

Here we report two qualitative models on failure and deformation mechanisms at macro- and nano-scales of alkali activated clay (AACL), a material of extraordinary importance as a low cost building material. The models were based on experimental data of compressive failure and nanoindentation response of the AACL materials. A 420% improvement in compressive strength (sigma(c)) of the AACL was achieved after 28 days (d) of curing at room temperature and it correlated well with the decrements in the residual alkali and pH concentrations with the increase in curing time. Based on extensive post-mortem FE-SEM examinations, a schematic model for the compressive failure mechanism of AACL was proposed. In addition, the nanoindentation results of AACL provided the first ever experimental evidence of the presence of nano-scale plasticity and a nano-scale contact deformation resistance that increased with the applied load. These results meant the development of a unique strain tolerant microstructure in the AACL of Indian origin. The implications of these new observations were discussed in terms of a qualitative model based on the deformation of layered clay structure

Nanomechanical responses of human hair

Here we report the first ever studies on nanomechanical properties e.g., nanohardness and Young's modulus for human hair of Indian origin. Three types of hair samples e.g., virgin hair samples (VH), bleached hair samples (BH) and Fe-tannin complex colour treated hair samples (FT) with the treatment by a proprietary hair care product are used in the present work. The proprietary hair care product involves a Fe-salt based formulation. The hair samples are characterized by optical microscopy, atomic force microscopy, field emission scanning electron microscopy, energy dispersive X-ray spectroscopy (EDAX) genesis line map, EDAX spot mapping, nanoindentation, tensile fracture, and X-ray diffraction techniques. The nanoindentation studies are conducted on the cross-sections of the VH, BH and FT hair samples. The results prove that the nanomechanical properties e.g., nanohardness and Young's modulus are sensitive to measurement location e.g., cortex or medulla and presence or absence of the chemical treatment. Additional results obtained from the tensile fracture experiments establish that the trends reflected from the evaluations of the nanomechanical properties are general enough to hold good. Based on these observations a schematic model is developed. The model explains the present results in a qualitative yet satisfactory manner. (C) 2015 Elsevier Ltd. All rights reserved