A comparative study to assess the awareness of antibiotic resistance amongst first and second year medical undergraduate students in a medical college

Background: With the rising instances of antibiotic resistance and decline in the discovery of newer antibiotics, it is high time to prevent the emergence of antibiotic resistance. One of the best measures regarding the above problem is education and creating awareness regarding antibiotic resistance, and that too primarily among healthcare professionals. The initiation should start at the basic level and that too in the early days of medical profession, so that there is greater awareness and strong foundation for antibiotic prescribing pattern. The present study is taken up to compare awareness among 1st year and 2nd year medical students in a private medical college with 2nd year medical students having prior education regarding antibiotics resistance and first year students representing general public without any education regarding antibiotics resistance.Methods: This study was a comparative, cross-sectional, questionnaire based study. The questionnaire was validated for face validity and content validity from subject experts. The two groups selected were 1st year and 2nd year medical undergraduates. Data was analysed using simple descriptive statistics.Results: 136 students from 1st year and 88 students from 2nd year participated in the study. In both the groups studied, majority of the respondents completed the full course of antibiotics. 77% of 1st year and all 2nd year students were aware of the antibiotic resistance. 99% of 2nd year students and only 49% of the 1st year students were aware of the reasons for it (p<0.01). Awareness regarding prophylactic usage of antibiotics, usage for simple common cold and usage of higher antibiotics for mid infection leading to Antibiotic Resistance was significantly less among first year students. 2nd year students were well aware of consequences of antibiotic resistance like ineffective treatment, prolongation of illness, emergence of bacterial resistance and additional cost burden than 1st year students. Awareness regarding other aspects of antibiotic resistance was not significant between two groups.Conclusions: Stressing upon awareness and education regarding antibiotic resistance in the early days of medical curriculum will help in change of behaviour and habits of antibiotic usage and rational prescribing of antibiotics by the future doctors.

A comparative study of probiotic, prokinetic based triple therapy with USFDA regimen in the eradication of Helicobacter pylori in a tertiary care hospital

Background: Helicobacter pylori infection has been associated with peptic ulcer disease, gastric carcinoma and gastric mucosa associated lymphoid tissue (MALT) lymphoma. Its eradication is important and current regimens are associated with antibiotic resistance, side effects and poor patient compliance. Probiotics supplementation can overcome the above problem and additions of prokinetics improve dyspepsia symptoms and thereby improve patient compliance. So the aim of the study was to compare efficacy and safety of standard United States Food and Drug Administration (USFDA) regimen with probiotic, prokinetic based novel regimen.Methods: 100 patients diagnosed with H. pylori infection were randomly assigned into two eradication regimen groups viz., group A and group B. Group A received standard USFDA regimen, amoxicillin 1 gm, lansoprazole 30 mg and clarithromycin 500 mg twice a day for 2 weeks and group B received a probiotic and prokinetic itopride 50 mg thrice daily, pantoprazole 40 mg, amoxicillin 1 gm and clarithromycin 500 mg twice daily for 2 weeks. Patients with Rapid Urease Test (RUT) and histopathology reports negative for H. pylori were considered as eradicated and then the percentage of eradication rate in both groups was compared.Results: H. pylori eradication rates were more in group B compared to group A (84% vs 70%, p =0.096 at 95% CI). The occurrence of side effects was less in group B compared to group A (30% vs 46%, p= 0.099). Diarrhoea was statistically less in group B compared to group A (p< 0.05).Conclusions: Probiotics supplementation increases eradication rates of anti H. pylori therapy and improves tolerability by reducing side effects especially diarrhoea. Prokinetics and probiotic based novel regimen improved dyspepsia symptoms and patient compliance

Assessment on awareness of rational prescribing practices among medical interns in a tertiary care hospital: a questionnaire based study

Background: Awareness about rational use of Medicines is required to improve the quality of health care system. Attitude towards rational drug use is also an utmost importance as they constitute the future generation doctors.Methods: A set of 13 questionnaire is given to the interns through an online link to their e-mail which contains informed consent and questionnaires. Respondents has to select the best suitable option and after which the data will be compiled and statistically analyzed.Results: Age of the study participants range from 22-26yrs. Half of them have finished major postings. Almost 96.1 % of them were aware of the term essential drugs. Only 25% of them said that they have NLEMI at work place, 75% of them were aware of the term Rational use of Medicines. Only 32% of them were aware of the term P drugs. 44% of them were aware of STEP criteria for selection of drug and 47% of them were aware of the updated prescribing format. 8% knew the difference between old and new prescription format, 25% of them always prescribe. Almost 82% of them narrate regarding the disease and drug therapy, 31% of them prescribe only generic name.Conclusions: Educational intervention like CME and practical hands on training in Rational use of Medicines would help them in better understanding of the subject and its clinical implications thereby decreasing the prescribing errors

Worldwide clinical intensive care registries response to the pandemic : An international survey

Funding Information: Dr. Kumar is partially supported by Wellcome Trust grant (WT-215522) for his role as National Coordinator, IRIS. Funding Information: Dr. Martin Sigurdsson is supported by Landspitali Science Fund for COVID19 related projects. Funding Information: Drs. Salluh and Soares are supported in part by individual research grants from CNPq and FAPERJ.Peer reviewe

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Multi-criteria ranking of corporate distress prediction models: empirical evaluation and methodological contributions

YesAlthough many modelling and prediction frameworks for corporate bankruptcy and distress have been proposed, the relative performance evaluation of prediction models is criticised due to the assessment exercise using a single measure of one criterion at a time, which leads to reporting conflicting results. Mousavi et al. (Int Rev Financ Anal 42:64–75, 2015) proposed an orientation-free super-efficiency DEA-based framework to overcome this methodological issue. However, within a super-efficiency DEA framework, the reference benchmark changes from one prediction model evaluation to another, which in some contexts might be viewed as “unfair” benchmarking. In this paper, we overcome this issue by proposing a slacks-based context-dependent DEA (SBM-CDEA) framework to evaluate competing distress prediction models. In addition, we propose a hybrid crossbenchmarking- cross-efficiency framework as an alternative methodology for ranking DMUs that are heterogeneous. Furthermore, using data on UK firms listed on London Stock Exchange, we perform a comprehensive comparative analysis of the most popular corporate distress prediction models; namely, statistical models, under both mono criterion and multiple criteria frameworks considering several performance measures. Also, we propose new statistical models using macroeconomic indicators as drivers of distress

A comparative study of probiotic, prokinetic based triple therapy with USFDA regimen in the eradication of Helicobacter pylori in a tertiary care hospital

Background: Helicobacter pylori infection has been associated with peptic ulcer disease, gastric carcinoma and gastric mucosa associated lymphoid tissue (MALT) lymphoma. Its eradication is important and current regimens are associated with antibiotic resistance, side effects and poor patient compliance. Probiotics supplementation can overcome the above problem and additions of prokinetics improve dyspepsia symptoms and thereby improve patient compliance. So the aim of the study was to compare efficacy and safety of standard United States Food and Drug Administration (USFDA) regimen with probiotic, prokinetic based novel regimen. Methods: 100 patients diagnosed with H. pylori infection were randomly assigned into two eradication regimen groups viz., group A and group B. Group A received standard USFDA regimen, amoxicillin 1 gm, lansoprazole 30 mg and clarithromycin 500 mg twice a day for 2 weeks and group B received a probiotic and prokinetic itopride 50 mg thrice daily, pantoprazole 40 mg, amoxicillin 1 gm and clarithromycin 500 mg twice daily for 2 weeks. Patients with Rapid Urease Test (RUT) and histopathology reports negative for H. pylori were considered as eradicated and then the percentage of eradication rate in both groups was compared. Results: H. pylori eradication rates were more in group B compared to group A (84% vs 70%, p =0.096 at 95% CI). The occurrence of side effects was less in group B compared to group A (30% vs 46%, p= 0.099). Diarrhoea was statistically less in group B compared to group A (p< 0.05). Conclusions: Probiotics supplementation increases eradication rates of anti H. pylori therapy and improves tolerability by reducing side effects especially diarrhoea. Prokinetics and probiotic based novel regimen improved dyspepsia symptoms and patient compliance. [Int J Basic Clin Pharmacol 2016; 5(1.000): 173-179