A cross sectional questionnaire based study on self medication practice of analgesics among MBBS students at Dr. B. R. Ambedkar Medical College, Bengaluru, Karnataka

Background: Self medication with analgesics is prevalent worldwide due to easy procurement of over the counter drugs. Present study was done to assess knowledge, attitude, practice and perception of self medication of analgesics among MBBS students at Dr. B. R. Ambedkar Medical College, Bengaluru, Karnataka.Methods: A cross-sectional study was conducted on 5th term MBBS students of Dr. B. R. Ambedkar Medical College, Bengaluru in November 2019.  A pre-designed validated questionnaire was used to collect information on knowledge, attitude, practice and perception of self medication of analgesics. Data was analysed using descriptive statistics.Results: 83.3 % of 5th term MBBS students practiced self medication with analgesics. Majority of students had some knowledge on self medication with analgesics. Common reason for using analgesic self medication was headache (59.7%) and nonsteroidal antiinflammatory drugs (90%) were commonly used analgesics. Analgesics were used for quick relief (73.3%) and source of information was from medical textbooks (61.6%). Students stopped taking analgesics after symptoms disappeared (75%). Students agreed that self medication is acceptable for medical students (63.3%) and medical license is required for better administration of drugs (51.3%).Conclusions: This study has found that self medication with analgesics was common among undergraduate medical students for minor illness. It is necessary to create awareness and educate students regarding dangers of analgesic self medication

A comparative study of the efficacy and tolerability of parenteral ceftriaxone and cefotaxime in pediatric population for acute bacillary dysentery in a tertiary care hospital

Background: Diarrheal disorders in childhood account for a large proportion (18%) of childhood mortality. Among diarrheal diseases, dysentery is a major cause of childhood morbidity and mortality, especially in developing countries.Methods: This is an open labelled, prospective, randomised, comparative study carried out at Dr. B. R. Ambedkar Medical College Hospital, Bangalore from November 2014 to November 2015 after Institutional Ethics Committee approval. A total of 80 Paediatric patients who met the inclusion criteria were included in the study after taking written informed consent from parents and assigned into two groups, Group A- Inj. Ceftriaxone (50-100mg/kg/day) and Group B- Inj. Cefotaxime (100 mg/kg/day) in divided doses for a period of 3-5 days based on requirement.Results: In this study, Cefotaxime was non inferior to Ceftriaxone as the Mean Duration of Hospitalisation was 3.30±0.72 days in Group A and 3.30± 0.72 days in Group B with p value of 1.000, showing no statistically significant difference. Both were well tolerated without any reports of ADR (Adverse Drug Reaction).Conclusions: In this study shows that Inj. Cefotaxime is equally efficacious and well tolerated as Inj. Ceftriaxone in the treatment of Acute Bacillary Dysentery in paediatric patients

A comparative study on self-medication practice of analgesics among MBBS students of Dr. B. R. Ambedkar Medical College, Bengaluru

Background: Self-medication with analgesics is prevalent worldwide among medical students due to easy availability of drugs and may lead to irrational usage of drugs. To assess knowledge, attitude, practice and perception of self-medication of analgesics.Methods: A comparative study on self-medication of analgesics was conducted on 3rd and 5th term Bachelor of medicine and Bachelor of Surgery (MBBS) students of Dr. B. R. Ambedkar Medical College, Bengaluru in November 2019. A pre-designed questionnaire was used to collect information on self-medication with analgesics.Results: 74.5% of 3rd term and 65.5% of 5th term MBBS students practiced self-medication with analgesics. Majority of students in both groups had some knowledge on self-medication with analgesics. Common condition for using analgesic self-medication was headache (75.8%, 59.7%, p=0.0172) and non-steroidal anti-inflammatory drugs (80.6%, 90%, p=0.0780) were commonly used analgesics. Analgesics were used for quick relief (67.7%, 73.3%, p=0.4512) and students in group II referred medical textbooks as a source of information for practicing self-medication with analgesics (22.5%, 61.6%, p<0.001). Students agreed that self-medication is acceptable for medical students (45.8%, 43%, p=0.045) and medical license is required for better administration of drugs (51.3%, 63.2%, p=0.225).Conclusions: This study has found that self-medication with analgesics was common among MBBS students for minor illness. It is necessary to create awareness and educate students regarding the hazards of self-medication

Prescription pattern of analgesics in orthopedics outpatient department at a tertiary care hospital

Background: Analgesics are the most common class of drugs prescribed for various conditions in the orthopedics outpatient department (OPD).This study is performed for a better understanding of analgesics prescribing pattern in orthopedics and to correlate the use of selective cyclooxygenase-2 (COX-2) inhibitors, conventional non-steroidal anti-inflammatory drugs (NSAIDs), and opioid analgesics in practice in the present scenario.Methods: The prescriptions from the OPD of Orthopedics at Dr. B. R. Ambedkar Medical College was reviewed between June 2013 and November 2013, entered in a pre-designed proforma. Pain was quantified using numeric rating scale. The type of analgesics administered, whether monotherapy or combined therapy and the duration of therapy, was analyzed to obtain an overview of the current prescribing pattern.Results: A total of 300 prescriptions were analyzed. 800 drugs were prescribed with an average of 2.6 drugs per prescription. Of these, 62.3% were NSAIDs, 15.4% were opioid analgesics and 22.3% were gastroprotective agents. 61% of the NSAIDs were prescribed as monotherapy and 39% were prescribed as fixed drug combination (FDC). The ratio of selective to non-selective NSAIDs is 1.3:1.Conclusions: The results of the present study show frequent use of selective COX-2 inhibitors, although non-selective NSAIDs topped the list of various selective NSAIDs, non-selective NSAIDs, and opioid analgesics. This suggests that gastrointestinal safety was an important concern while prescribing these drugs. Many FDCs were found to be irrational

Prescribing pattern of drugs in alcohol dependence in a tertiary care hospital

Background: Alcohol dependence is one of the more serious public health issues in the world. It not only affects health but is also a social and economic burden. Pharmacotherapy is the main stay of treatment along with behavioural therapy for alcohol addiction. The present study was done to analyse the prescribing pattern of drugs used in alcohol dependence.Methods: The present study is a retrospective study which was carried out in the Department of Psychiatry, Dr. B.R. Ambedkar Medical College, Bengaluru from March 2016 to August 2016. Demographic, disease and treatment details were collected and entered in the case proformas. The results were analyzed using descriptive statistics.Results: A total of 125 prescriptions were analyzed. The most common age group was between 30-60 years with a male predominance (95.2%). 72% of patients were treated for alcohol dependence whereas 28% who had other co morbidities like psychosis and depression were treated appropriately. The most commonly prescribed drugs were Vitamins (74.4%), Benzodiazepines (BZDs) (56.8%), anti-craving drugs (52%), antipsychotics (20%) and anti-depressant drugs (8%). Lorazepam (45.6%) and Baclofen (46.1%) were the most common drugs prescribed among BZDs and Anti-craving drugs respectively. For affective disorders Olanzapine (36%) was the commonest drug prescribed.Conclusions: This study reveals that alcohol dependence is accompanied by other co-morbidities like psychosis, depression and anxiety. Combined therapy of Vitamins, BZDs, Anti-craving drugs along with Antipsychotic or Antidepressant drugs have been prescribed to the patients. Newer anti-craving drugs like Baclofen, Acamprosate and Naltrexone have also been prescribed

Drug-induced cutaneous adverse drug reactions in dermatology in Dr. B.R. Ambedkar Medical College

Background: Cutaneous adverse drug reactions (ADRs) affect 2-3% of hospitalized patients. The severity varies from mild itching to life-threatening Stevens-Johnson syndrome (SJS). Hence, this study was undertaken to emphasize the need to report ADRs.Methods: The study was carried out in the Department of Dermatology in Dr. B.R Ambedkar Medical College Hospital from June to December 2012. Naranjo’s algorithm was used to determine the causality of an ADR. Informed consent was obtained from each patient, and thorough clinical examination was conducted. All the information was carefully recorded in a pre-designed proforma. To establish the etiologic agent for a particular type of reaction, attention was paid to the drug history, temporal correlation with the drug, duration of the reaction, morphology of the reaction, associated mucosal or systemic involvement, improvement of lesions on withdrawal of the drug.Results: In the present study, all the age groups were affected with cutaneous ADRs, with a higher incidence in age group between 31 and 40 years, non-steroidal anti-inflammatory drugs (NSAIDs) (41.66%) were most commonly observed drug, followed by anti-microbials (25%) and anti-convulsants (21.66%). Fixed drug eruptions (FDE) (46.66%) most commonly observed cutaneous reaction, followed by SJS (16.66%), erythema multiformae (16.66%) most commonly observed ADRs.Conclusions: ADRs are potentially avoidable causes for seeking medical care. FDE was most common ADR and NSAIDs were most common causative agents in our study. ADRs can be prevented by avoiding polypharmacy, obtaining history of any previous skin reaction and the causative agent

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

Reducing Chemical Exposures at Home: Opportunities For Action.

Indoor environments can influence human environmental chemical exposures and, ultimately, public health. Furniture, electronics, personal care and cleaning products, floor coverings and other consumer products contain chemicals that can end up in the indoor air and settled dust. Consumer product chemicals such as phthalates, phenols, flame retardants and per- and polyfluorinated alkyl substances are widely detected in the US general population, including vulnerable populations, and are associated with adverse health effects such as reproductive and endocrine toxicity. We discuss the implications of our recent meta-analysis describing the patterns of chemical exposures and the ubiquity of multiple chemicals in indoor environments. To reduce the likelihood of exposures to these toxic chemicals, we then discuss approaches for exposure mitigation: targeting individual behaviour change, household maintenance and purchasing decisions, consumer advocacy and corporate responsibility in consumer markets, and regulatory action via state/federal policies. There is a need to further develop evidence-based strategies for chemical exposure reduction in each of these areas, given the multi-factorial nature of the problem. Further identifying those at greatest risk; understanding the individual, household and community factors that influence indoor chemical exposures; and developing options for mitigation may substantially improve individuals’ exposures and health

Association between maternal folate concentrations during pregnancy and insulin resistance in Indian children

AIMS/HYPOTHESIS: In an Indian birth cohort, higher maternal homocysteine concentration in pregnancy was associated with lower birthweight of the offspring. Lower maternal vitamin B12 and higher folate concentrations were associated with higher offspring insulin resistance. Disordered one-carbon metabolism during early development may increase later metabolic risk. We explored these associations in another birth cohort in India at three age points.METHODS: We measured plasma vitamin B12, folate and homocysteine concentrations at 30 ± 2 weeks' gestation in 654 women who delivered at one hospital. Neonatal anthropometry was recorded, and the children's glucose and insulin concentrations were measured at 5, 9.5 and 13.5 years of age. Insulin resistance was estimated using HOMA of insulin resistance (HOMA-IR).RESULTS: Maternal homocysteine concentrations were inversely associated with all neonatal anthropometric measurements (p < 0.05), and positively associated with glucose concentrations in the children at 5 (30 min; p = 0.007) and 9.5 years of age (120 min; p = 0.02). Higher maternal folate concentrations were associated with higher HOMA-IR in the children at 9.5 (p = 0.03) and 13.5 years of age (p = 0.03). Maternal vitamin B12 concentrations were unrelated to offspring outcomes.CONCLUSIONS/INTERPRETATION: Maternal vitamin B12 status did not predict insulin resistance in our cohort. However, associations of maternal homocysteine and folate concentrations with birth size, and with childhood insulin resistance and glycaemia in the offspring, suggest a role for nutritionally driven disturbances in one-carbon metabolism in fetal programming of diabetes