HEMOGLOBIN STATUS OF FEMALE MEDICOS IN URBAN AREA AND FACTORS AFFECTING IT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY

ABSTRACTObjectives: Estimating the hemoglobin (Hb) status in female medicos through prospective cross-sectional study and assessment of influencing ofcofactors were objectives.Methods: Women medicos who volunteered, consented and met selection criteria were enrolled. Hb level was estimated to diagnose anemia.Relationship with influencing factors was assessed statistically.Result: A total of 100 eligible students were enrolled. Mean age±standard deviation (SD) age of the participants' was 20.9±3.1 years (17-25 years).Mean±SD Hb was 12.25±1.0189 g% (9.0-16.0 g%). 33 were anemic, and mild anemia (32%) was frequent. There was a history of worm infestation inthree students (3%), who were treated adequately. Nine were on iron supplements of which five were still anemic and were continuing the treatmentby the end of the study. 28 (84.84%) anemic students were not on any iron or hematinic treatment. There was no association between the anemiaand nature of diet, consumption of green leafy vegetables, consumption of coffee/tea after food, smoking/tobacco or alcohol consumption, mother'seducation, socioeconomic status, menstrual factors, and physical exercise. The prevalence of anemia was found to be higher in underweight andoverweight students in comparison to students with normal body mass index.Asymptomatic participants (n=78) outnumbered symptomatic ones(n=22), but without any statistical significance. Easy fatigability (14%), pallor (7%), breathlessness (6%), weakness (9%), and easy bruising (1%)were frequent complaints.Conclusion: Anemia is frequent among women medicos, often underdiagnosed, under-reported, many remaining asymptomatic. Negligence ofmedical students toward their anemic status despite the awareness of consequences of low Hb level is a serious cause of concern.Keywords: Awareness, Hemoglobin, Nutritional anemia, Women medical students

A cross sectional knowledge attitude practice study on therapeutic drug monitoring among health care professionals in a tertiary care hospital

Background: Therapeutic drug monitoring (TDM) is used to optimize drug’s therapeutic effect. Aim of this study is to assess the knowledge, attitude and practice of TDM in health care professionals.Methods: This was a questionnaire-based cross-sectional study. Questionnaires were distributed to 610 nursing staff and 20 lab technicians. Questionnaires had queries on demography, knowledge, attitude and practice. Descriptive statistics and Pearson correlation were used to analyse the data.Results: Among nurses, 7% had good, 60.9% had   fair and 32.2% had poor knowledge of TDM. Among lab technicians 18.2% had good and 81.8% had fair knowledge on TDM. 79.3% of nurses and all lab technicians had favourable attitude towards TDM. Weak positive correlation is seen between knowledge and attitude among nurses. 15.9% of nurses have sent request for TDM on phenytoin, sodium valproate, carbamazepine, methotrexate, lithium, clozapine, risperidone, tigecycline, vancomycin, gentamicin, digoxin and amiodarone. 100% lab technicians have estimated levels of methotrexate and lithium drug sample during the last one year.Conclusions: Though knowledge on indication and pharmacological basis of TDM is lacking among participants, their knowledge on sample collection and sample type is good. They have a positive attitude towards TDM. Nurses have requested TDM for only 12 drugs. TDM of only two drugs was done by lab technicians. Future training should focus on pharmacological basis, selection of appropriate drug candidate and indication for TDM service. TDM service should be made available in all tertiary care institutions

Simulation based learning methodology in pharmacology: knowledge and perception among second year medical under-graduate students

Background: Simulation-based learning (SBL) enhances problem-solving, improves skills in health care professionals. Authors assessed its use in teaching and learning pharmacology among medical undergraduates exposed to METIman, human patient simulator.Methods: Medical undergraduate students exposed to SBL for over a year (8 clinical pharmacology related scenarios) were asked to fill a validated questionnaire at the end of the academic year.Results: Of 145 students who underwent SBL, the data of 84 were analysed. The overall satisfaction score with SBL was highly significant in 79 (94%) with a score of 26-35. Participants opined that it increases the depth of experience (91.6%), provides a no risk learning and immediate feedback opportunity (93.4%), a good opportunity to come across rare scenarios (86.2%), enhances decision making, communication, teamwork and skill development (92%); opportunity of repeated learning and enhanced patient safety at hospitals (89.28%), reduces the dependency on patients (72.8%), good opportunity for crisis training (88.0%) were other factors favouring the use of SBL. Preference for an increase in the number of classes allotted to simulation (27.4%) and reducing the duration of class (9.6%) were the major suggestions. It is an excellent method to teach and make it interesting to learn pharmacology (80.0%)Total score varied between 23-35 with a mean±SD of 35±30.64. None had a score of 7-15.Conclusions: SBL is an effective teaching and learning methodology with adequate participant satisfaction. It can be of immense utility as a learning tool with better outcome in learning, retention and recall

A cross-sectional study to assess the adverse effect profile of second generation antipsychotics: risperidone, olanzapine and quetiapine

Background: Pharmacovigilance is the scientific approach to a drug related problem.  Psychotropic drugs are known to cause several adverse drug reactions (ADRs).  This study aimed to assess the adverse effect profile of 3 second generation antipsychotics-risperidone, olanzapine and quetiapine in patients on monotherapy of any of these second generation antipsychotics.Methods: This was a hospital based cross-sectional study conducted in psychiatric outpatient department of Psychiatry in Father Muller Mental Health Centre, Mangalore. The study sample consisted of patients suffering from schizophrenia and other psychotic disorders according to ICD 10 criteria (F20- F29) and who were maintaining remission  on any one of the second generation antipsychotics viz risperidone, olanzapine or quetiapine.Results: Out of 154 subjects, 68 were on risperidone, 74 were on olanzapine, and 12 were on quetiapine. Most common ADRs reported were increased appetite (26%), weight gain (15%), tremors (14%), fatigue (14%), constipation (14%), dyspepsia (10%), somnolence (12%), decreased appetite (10%). Among these ADRs none of them were preventable and belonged to mild to moderate severity. Causality of adverse events was assessed by Naranjo algorithm; a probability scale for ADR. Severity was assessed by modified Hartwig and Seigel scale. Preventability was assessed using Schumock and Thronton criteria.Conclusions: The most common ADRSs reported with SGAs were increased appetite and weight gain and the frequency of ADRs were higher with subjects receiving risperidone

Can occupational exposure to antineoplastic drugs increase levels of an inflammatory trigger?

Background: Antineoplastic drugs (AND) are known to cause collateral damage to normal cells by oxidative stress. This study was conducted to check for oxidative stress in occupational exposure to these drugs using advanced oxidation protein products (AOPP).Methods: Cross-sectional comparison of serum AOPP levels of 33 nurses occupationally exposed and serum AOPP levels of 30 nurses not exposed using modified AOPP method.Results: Serum AOPP levels were significantly increased (p<0.001) in the exposed group (16.66±3.31) compared to the unexposed group (12.87±2.62).Conclusion: This study highlights oxidative stress in the form of protein oxidation occurring in nurses exposed to AND

Comparative study of the efficacy and safety of olopatadine eyedrops and sodium cromoglycate in clinical practice: a prospective study

Background: Allergic eye diseases are the commonest causes of ocular morbidity worldwide. To choose the best therapy in allergic conjunctivitis, understanding of underlying mechanisms implicated in triggering the allergy is very important. Olopatadine with a wide spectrum has proven to be very effective in allergic conjunctivitis. The objective of the study was to compare the efficacy and safety of ophthalmic solutions of olopatadine 0.2% once daily, olopatadine 0.1% twice daily and sodium cromoglycate 2% four times daily in allergic conjunctivitis for 3 weeks.Methods: This was a prospective, single centre study enrolling 304 patients with allergic conjunctivitis attending ophthalmology clinics. Subjects were assessed for ocular signs and symptoms at 3 visits-baseline, week 2, week 3. The change from baseline in the mean scores of itching and redness at 3 weeks was primary outcome variable.Results: The reduction in signs and symptoms were statistically significant in all the three groups (p <0.001). Both the olopatadine receiving groups were better than sodium cromoglycate receiving group in reducing ocular signs and symptoms by pairwise comparison by wilcoxon signed rank test.Conclusions: Olopatadine ophthalmic solution is better than sodium cromoglycate ophthalmic solution in reducing the ocular signs and symptoms in allergic conjunctivitis

Comparison of efficacy of atropine versus atropine with pralidoxime in organophosphorus poisoning

Background: Comparison of the efficacy of atropine alone against atropine with pralidoxime in the treatment of organophosphorus (OP) poisoning.Methods: Forty two patients between the age group of 18 to 65 years, treated for OP poisoning and matched for baseline characteristics, were included in two groupsbased on treatment received as “Atropine only” or “Atropine plus pralidoxime(PAM)”.Main outcomes of the study were ICU stay, total hospital stay and mortality. ICU and hospital stay were compared using ‘t’ test while  mortality was compared using Fisher’s exact test.Results: Total hospital stay was not significantly different between the treatment groups (95% CI of difference: -4.227, 0.784). Length of stay was also not significantly different between patients who received atropine plus PAM within 6 hours of consumption of poison and those who received 6 hours later (95% CI of difference: -4.154, 0.954; p value: 0.2). Conclusion: Our data supports the use of only atropine over atropine plus PAM in patients with OP poisoning on account of no significant difference /reduction of hospital/ICU stay and mortality in the latter group. However, a study with a larger sample needs to be conducted, to be able to draw a definitive conclusion

Correlation of serum lithium levels and thyroid function tests in subjects of bipolar affective disorder: a prospective hospital-based study

Background: Lithium is used in the prophylaxis of long-term therapy of bipolar affective disorder (BPAD) as a mood-stabilizing agent. Thyroid function abnormality is very commonly seen adverse effect, more common in females than males. This study aimed to correlate lithium levels and thyroid function abnormalities associated with it.Methods: Evaluation of medical records of 150 patients in Father Muller Medical College with BPAD, who were treated for 6 months with lithium, carried out from February, 12 2014 to July, 20 2014. Serum lithium levels done by ion selective electrode method in ilyte analyzer and thyroid function test (TFT) by electrochemiluminescence. Data are analyzed by Karl Pearson correlation coefficient.Results: Correlation of lithium levels and TFT in BPAD patients according to Karl Pearson correlation coefficient was negative with significant p&lt;0.002. Among 150 enrolled candidates, 52 (34.67%) were females and 98 (65.4%) were males, 4% (6) patients (3 males and 3 females) had thyroid stimulating hormone (TSH) value &lt;0.27 with an average lithium value of 1.35 mEq/L, 6% (9) patients (5 males and 4 females) had TSH value &gt;4.2 with an average lithium levels of 0.44 mEq/L and 90% of the patients with an average lithium levels 0.66 mEq/L had no thyroid function abnormalities.Conclusions: As already known, Lithium is a drug of narrow therapeutic index and females are more prone for thyroid function abnormalities. Appropriate monitoring of serum lithium levels will aid in necessary dose adjustment and ensure proper utilization of drug

Discovery of artemisinin: The Chinese wonder drug

Artemisinin, a great boon to the patients of multidrug-resistant malaria, has an equally amazing history. Although used by the Chinese herbal healers centuries ago, its introduction to the modern system of medicine was preceded by extensive research. The success of ′project 523′ is further evidence to the medical fraternity that collaborative research can yield rich dividends. Although many claim credit, Dr. Youyou Tu was awarded the Lasker prize for the feat