A comparative study of interactive and conventional teaching methods in pharmacology for better clinical application

Background: Pharmacology forms the basis of practice of medicine yet most students perceive it as a difficult subject. It is necessary that a student gains knowledge and retains the gained knowledge for better application in the future. But the method employed now is more passive with less emphasis on clinical application.Methods: The study population was the second year MBBS students of Terna Medical College, Navi Mumbai. The students were randomly divided into two groups; a didactic and an interactive lecture session were conducted on two days. A pre validated questionnaire, pre-test and post-test were employed in the study. The data of pre and post-test were analysed using paired t-test and descriptive analysis for the questionnaire.Results: The difference in short term learning outcomes between both the didactic and interactive lecture sessions was not statistically significant (p=0.53). The students showed a positive reaction to interactive sessions. 70 (95.89%) agreed that interactive sessions has increased their understanding of the topic better. 70 (95.89%) students responded that interactive teaching has increased their ability to apply knowledge therapeutically.Conclusions: In the present study it was observed that though there was not much statistically significant improvement in the immediate understanding, the perception of students towards interactive teaching methods is good

Drug prescribing patterns in elderly patients in a tertiary level hospital

Background: Elderly people have multiple co morbidities and are often prescribed potentially inappropriate medications (PIMs). As there is paucity of information about the prescribing practices in elderly this study was undertaken to assess drug utilization patterns in elderly patients.Methods: A prospective observational study was conducted in a tertiary care hospital. A total of 576 prescriptions of elderly patients were included in the study. Prescribing patterns among elderly patients attending OPD and admitted to wards of departments of Medicine, Psychiatry, Dermatology, Pulmonary Medicine, General Surgery, E.N.T., Ophthalmology, Orthopaedics, Obstetrics and Gynaecology were analysed using the prescribing indicators (WHO criteria). The PIMs were identified as per the Beers 2012 criteria.Results: The average number of drugs per patient was 3.91±1.93 for O.P.D and 7.37 ±2.22 for I.P.D. patients. 37.76% patients in I.P.D. and 26.87% patients in O.P.D. received a medication which was potentially inappropriate as per Beers 2012 criteria. 7.58% (234/3088) of total medications prescribed to patients in the study were potentially inappropriate. There was a significant increase in the number of PIMs (p value ˂0.05) as the total number of drugs prescribed increased.Conclusions: Educational programmes are needed to reinforce rational prescribing by physicians and precautions should be taken while prescribing potentially inappropriate drugs to elderly patients

Drug prescribing pattern in acute gastroenteritis in an in-patient setting in a private hospital

Background: Diarrheal diseases cause significant morbidity in developing countries and are the leading cause of death in children. The study was undertaken to assess drug utilization patterns in patients with gastroenteritis in a private setting.Methods: The in-patient data records of 208 patients (96 males, 112 females) admitted with acute gastroenteritis in a private hospital in Mumbai over 2 years were analysed. WHO core drug prescribing indicators - average number of drugs per prescription, percentage of drugs prescribed by generic name, percentage of encounters resulting in prescription of an antibiotic, percentage of encounters resulting in prescription of an injection were assessed. Patient demographics and trends in use of antibiotics, antiemetics and antidiarrheals were assessed.Results: The average total number of drugs prescribed per patient was 6.33 and average number of antibiotics was 1.61. 99% of drugs were prescribed using brand names. Percentage of encounters resulting in prescription of injection was 97.11%. Cephalosporins were the most commonly used group of antimicrobials (62.5%) followed by fluroquinolones (49.03%) and antiamoebic drugs (35.58%). Diphenoxylate was the most commonly prescribed antidiarrheal drug and ondansetron was the most commonly prescribed antiemetic agent. Cephalosporins were the most commonly used antimicrobials in patients diagnosed with enteric fever.Conclusions: Emperical irrational use of antibiotics was observed. There was paucity of stool culture for identification of causative agents. Review of antibiotic susceptibility patterns needs to be done on a regular basis. Educational programmes to reinforce the need for ORS and zinc supplementation are necessary.

Correlation of body mass index, waist circumference and waist-hip ratio to fasting blood sugar levels in non-diabetics: an observational study

Background: Obesity is a serious health problem across the world. Obesity is an independent risk factor for diabetes and cardiac problems. Waist-hip ratio and waist circumference are better predictors of obesity and associated medical risks. The aims and objectives of study are to evaluate overweight and obesity in non-diabetics and assess correlation of BMI, WC and WHR with fasting blood sugar (FBS).Methods: A prospective study was carried out at D.Y. Patil Hospital Nerul, Navi Mumbai between November 2014- December 2014. Subjects attending the medical outpatient department (OPD) were invited to participate in this study. 200 subjects were screened, of whom 100 subjects having fasting sugar levels less than 110 mg/dL were enrolled. The subjects were matched with respect to age, BMI, waist circumference and Hip circumference and W: H ratio. BMI, WC and W:H ratio was correlated with FBS using Pearson’s correlation coefficient. Statistical significance was considered at P value<0.05.Results: It indicated 19.6% males (10/51) and 14.28% females (7/49) were overweight and 47.05% males (24/51) and 42.85% females (21/49) were obese according to BMI. 13.72% males (7/51) and 20.40% females (10/49) were overweight and 66.66% males (34/51) and 38.77% females (19/49) were obese according to WC. 5.88% males (3/51) and 4.08% females (2/49) were overweight and 94.11% males (48/51) and 91.83% females (45/49) were obese according to WHR.Conclusions: It can be concluded from this study that there is a positive correlation between BMI, Waist circumference, Waist: Hip Ratio and are important indicators of obesity to predict obesity

Correlation of Vitamin D deficiency with Type 2 diabetes and metabolic traits in the Indian population

Background: In India, 30-50% of children and 50-80% of adults are Vitamin D deficient. Limited data exists to assess the association of Vitamin D status, Type 2 diabetes (T2D), and metabolic traits in Indians. This study was conducted to assess the correlation of Vitamin D deficiency with T2D and metabolic risk factors in the Indian population.Methods: Patients of either gender visiting medicine outpatient department over a period of 1-year and with Vitamin D deficiency (levels <20 ng/ml), not taking Vitamin D supplements and having T2D were selected for the study. Participants were tested for serum Vitamin D, fasting blood sugar, and lipid profile parameters. Correlation between Vitamin D deficiency and blood sugar and Vitamin D deficiency and lipid profile was assessed using Pearson’s correlation test.Results: Out of 144 subjects, number of diabetic patients were 74 (51.38%) and non-diabetic patients were 70 (48.61%). Among diabetic patients, 10/74 (13.51%) were Vitamin D deficient and among non-diabetic patients, 20/70 (28.57%) were Vitamin D deficient. There was an inverse correlation between Vitamin D and total cholesterol (p=0.01) and Vitamin D and low-density lipoprotein (p=0.01), and it was statistically significant (p<0.05).Conclusion: Assessment of Vitamin D levels can be useful in diabetic patients as its deficiency is associated with T2D

Correlation of body mass index, waist circumference and waist-hip ratio to fasting blood sugar levels in non-diabetics: an observational study

Background: Obesity is a serious health problem across the world. Obesity is an independent risk factor for diabetes and cardiac problems. Waist-hip ratio and waist circumference are better predictors of obesity and associated medical risks. The aims and objectives of study are to evaluate overweight and obesity in non-diabetics and assess correlation of BMI, WC and WHR with fasting blood sugar (FBS).Methods: A prospective study was carried out at D.Y. Patil Hospital Nerul, Navi Mumbai between November 2014- December 2014. Subjects attending the medical outpatient department (OPD) were invited to participate in this study. 200 subjects were screened, of whom 100 subjects having fasting sugar levels less than 110 mg/dL were enrolled. The subjects were matched with respect to age, BMI, waist circumference and Hip circumference and W: H ratio. BMI, WC and W:H ratio was correlated with FBS using Pearson’s correlation coefficient. Statistical significance was considered at P value&lt;0.05.Results: It indicated 19.6% males (10/51) and 14.28% females (7/49) were overweight and 47.05% males (24/51) and 42.85% females (21/49) were obese according to BMI. 13.72% males (7/51) and 20.40% females (10/49) were overweight and 66.66% males (34/51) and 38.77% females (19/49) were obese according to WC. 5.88% males (3/51) and 4.08% females (2/49) were overweight and 94.11% males (48/51) and 91.83% females (45/49) were obese according to WHR.Conclusions: It can be concluded from this study that there is a positive correlation between BMI, Waist circumference, Waist: Hip Ratio and are important indicators of obesity to predict obesity