Animesh Jain

Self-medication patterns among medical students in South India

BACKGROUND Self-medication results in wastage of resources, increases resistance of pathogens and generally causes serious health hazards such as adverse drug reactions, prolonged suffering and drug dependence. This study was undertaken to determine the reasons for self-medication and the pattern of self-medication among medical students. METHOD This cross-sectional descriptive study was conducted at the K.S. Hegde Medical Academy, Mangalore. The participants were medical students from first to final year. Medical students were selected through convenience sampling. The data was collected using a pre-tested semi-structured questionnaire. The data was analysed using SPSS version 16 and the results expressed as proportions. RESULTS A total of 200 students, 121 (60.5%) female and 79 (39.5%) male, were included in the study. Of the medical students surveyed, self-medication was reported among 92%. The respondents who used self-medication found it to be time- saving in providing relief from minor ailments. The most common ailments for which self-medication were used were: the common cold (69%), fever (63%) and headache (60%). The students consulted their textbooks (39%) and seniors or classmates (38%) for the medications. Antipyretics (71%), analgesics (65%), antihistamines (37%) and antibiotics (34%) were the most common self- medicated drugs. Of the respondents, 33% were unaware of the adverse effects of the medication and 5% had experienced adverse reactions. The majority (64%) of students advised medications to others, more often to family and friends. CONCLUSION The prevalence of self-medication among medical students is high, facilitated by the easy availability of drugs and information from textbooks or seniors. A significant number of students are unaware of the adverse effects of the medication that they themselves take and suggest to others. Therefore, potential problems of self-medication should be emphasised to the students.

Prevalence of depression and its associated factors using Beck Depression Inventory among students of a medical college in Karnataka

Background and Objective: Depression among medical students is an area of increasing concern worldwide. This study aimed to assess the prevalence of depression and its associated factors among medical students. Materials and Methods: A stratified random sample of 400 students was assessed using Beck Depression Inventory by investigators. Associations between depression and class of studying, social factors like alcohol use, drug addiction, family problems, family history of depression, and staying away from home were analyzed by univariate analysis. Results: The overall prevalence of depression was found to be 71.25%. Among those with depression, a majority (80%) had mild and moderate degree of depression. The study showed that 46.3% (132) of the depressed were females and 53.7% (153) were males. According to cut-off scores, 115 students (29.8%) scored as normal (0-9), 111 (27.8%) as mild (10-18), 117 (29.3%) as moderate (19-29), 30 (7.5%) as severe (30-40), and 27 (6.7%) as very severe (>40) depression. The prevalence of depression was comparatively less among 1st and 2nd year medical students (57% and 50%, respectively) and the difference between the grade of depression and year of studying was found to be significant (χ2=122, P<0.001). The prevalence was significantly more among those with family problems and family history of depression. Conclusion: Depression is highly prevalent among medical students in this area. Our findings point to the importance of broad screening and psychiatric counseling of this vulnerable population.

Two wheeler accidents on Indian roads - a study from Mangalore, India

INTRODUCTION The alarming increase in mortality and morbidity owing to road traffic accidents has been a matter of great concern globally. This study was undertaken to find the trend of two wheeler accidents over the five years (2000-2004) with respect to age and sex of the victim, type of injury sustained, type of vehicle involved and time distribution of accidents. METHODS Data was retrospectively collected from the records at the Regional Transport Authoritys office, office of superintendent of police and also from both the Traffic police stations of the Mangalore city. Results were tabulated and the analysis was done using SPSS version 10. Test of significance was applied and p value <0.05 was taken to be significant. RESULTS A total of 1231 two wheeler accidents were recorded during 2000-2004. Majority (77%) of the victims were in the age group 18-44 years. Accident rate among males (83%) was higher than that among females (17%). Five percent of the victims (n=75) succumbed to injuries, of whom 45 died on the spot. Geared vehicles (81%) were more commonly involved than those without gears. Highest number of accidents was seen during 6-10 pm. CONCLUSION There is considerable morbidity and mortality due to two wheeler road traffic accidents. Among the fatalities majority died at the spot. Hence first aid measures at the spot would be of great help. It is recommended to have a good support system and para medical training for the people manning the ambulance. Awareness should be created among general public. Besides, every road traffic injury case has medicolegal elements involved. In India, as per law, every road traffic injury case is registered as a medicolegal case and investigated for prosecution concerns and compensation needs.

Health and environmental sanitation in India: Issues for prioritizing control strategies

Environmental sanitation is a major public health issue in India. Recent interventional studies on environmental sanitation in India highlighted the importance of prioritizing control strategies. Research related to the appropriate cost-effective intervention strategies and their implementation in Indian context is a big challenge. This paper discusses various intervention strategies related to environmental sanitation in India and emphasizes to prioritize it according to the need of country.

Suicidal ideation among students of a medical college in Western Nepal: A cross-sectional study

Many studies have been conducted in the developed countries to know the magnitude and factors influencing suicidal ideation among medical students, but such data are sparse in developing countries. This cross-sectional study was therefore conducted to find out the prevalence of suicidal ideation and factors influencing such ideation among students of a medical college in Western Nepal. A total of 206 students were selected using random sampling and questioned about their socio-demographic factors, other risk factors and suicidal ideation using a preformed validated questionnaire. The data were analyzed using SPSS for Windows Version 16.0 and the EPI Info 3.5.1 Windows Version. Descriptive statistics and testing of hypothesis were applied for the statistical methodology. The univariate and multivariate logistic regression methods were used to examine the association between different variables. Suicidal ideation in the last one year was present in nearly one tenth of the study population and in almost one fifth of them life-time suicidal ideation was present. Factors that were associated with suicidal ideation were primarily dissatisfaction with academic performance, being in the clinical semesters, having history of drug abuse and feeling neglected by parents. Most common reason reported for suicidal ideation was family related followed by self-related. Recognition of suicidal ideation among students and their associated factors can help in detecting it on time, making the right interventions and controlling the problem. Understanding the magnitude of the problem and their epidemiology via scientific study like this would be the first step in this process.

Prevalence of bronchial asthma in rural Indian children: A cross sectional study from South India

ObjectiveTo determine the prevalence and to study the socio-demographic correlates of bronchial asthma among children aged 6–15 yr.MethodsThis is a cross-sectional community based study conducted by interview of parents of randomly selected 559 children using an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.ResultsThe prevalence of bronchial asthma was found to be 10.3%. The prevalence of asthma was higher among boys (12.1%). There was a significant inverse linear trend with increasing age. A statistically significant association of bronchial asthma with family history of asthma was also observed.ConclusionThere is a high prevalence of bronchial asthma among children with a higher prevalence among boys than girls. There were significant inverse linear association with increasing age and also with family history of asthma. Efforts should be directed towards screening and early detection among the children, especially those of parents with history of asthma to enable treatment and reduce morbidity.

Cadaveric fungi: Not yet an established forensic tool

Forensic mycology is a broad field where fungal science and the judicial system interact. The application of field mycology in the location of scenes of crime concealed in forest ecosystems, and as a potential tool to assist in the estimation of post-burial interval in forensic investigations involving clandestine grave sites, has been suggested by Carter and Tibbett. They reported that fungi provide visible markers of the sites of cadaver decomposition and follow repeated patters of successional change as apparent decomposition proceeds. Indeed there is a growing interest in suggesting the potential forensic use of fungi detected on human cadavers too. To the best of our knowledge, for the first time Ishii et al. described in detail the taxonomical determination of species of fungi detected on human cadavers, and the forensic implications of cadaveric fungi have already been questioned. In a recent article entitled ‘‘Fungi can be a useful tool’’, Hitosugi et al. presented a medicolegal autopsy case in which fungi detected on a human cadaver contributed in estimating postmortem interval. To be accepted by the practicing forensic fraternity, however, the scientific basis for the same has not been satisfactorily explained by Hitosugi et al. Therefore, the use of cadaveric fungi as a forensic tool in estimating time since death at autopsy as reported in the aforementioned case may not be applicable without any appropriate reasoning. In the absence of data about the rate of growth of fungi on human cadavers or other cadavers, and the factors influencing their growth on cadavers, it is not scientific to note that cadaveric fungal evidence indicated that the deceased had been dead for about 10 days. The authors probably estimated time since death as 10 days based on changes in the body after death and corroborative police information, and not on cadaveric fungal evidence. We emphasize that additional practical forensic case series analyzing the fungal growth on human cadavers at different climatic conditions, and experimental studies should be reported to broaden our knowledge of their biology and behaviour in forensic cases, and to encourage a high level of competency in the field of forensic mycology before it is put into forensic practice. However, the use of human cadav-

Clinicomicrobiological analysis of patients with cholangitis

Acute cholangitis is inflammation of biliary ductal system from infection with an associated biliary obstruction. This retrospective study was done to determine the factors responsible for cholangitis and the microbiological profile of the bile in patients with cholangitis. In the study involving 348 patients, 36.4% had associated malignancy. A total of 54% of the bile samples were positive for aerobic culture. Nearly 66-73% of the Escherichia coli and Klebsiella isolates were Extended spectrum beta lactamases (ESBL) producers. Two isolates of Candida spps were also obtained. Polymicrobial infection was seen in 31.5% of the culture positive cases. Ideal antibiotics in case of cholangitis would be those which are excreted in the bile such as third-generation cephalosporins, ureidopenicillins, carbapenems and fluoroquinolones to combat resistance and polymicrobial aetiology. Anti-fungal drugs may also be necessary if the patient is not responding to biliary decompression and antibacterial agents to prevent fungaemia.

Perception and practice regarding infection control measures amongst healthcare workers in district government hospitals of Mangalore, India

Introduction: Healthcare workers must know the various measures for their own protection. They should improve organization of work, implement standard precautions and dispose biomedical waste properly to prevent occupational exposure. This study aimed at assessing the perception and practice of infection control measures amongst the healthcare workers in Mangalore. Materials and Methods: This cross-sectional study was conducted by using a pretested semi-structured proforma, by interview cum observational technique. One hundred and twenty healthcare workers (70 hospital staff including nurses and technicians at the two Government District Hospitals and 50 final-year MBBS students) were selected using convenient sampling and their perception and practice regarding infection control measures were studied. Results: Of the 120 participants, the majority (85.8%) was aware of disposing used needles and syringes in puncture-resistant containers but only 55.7% were actually practicing it. Three-fourths (75.8%) of the participants were aware about not recapping the needles after use but on observation, only 35.4% were practicing this. All healthcare workers were aware about the indication for using masks and gloves while handling patients, while only 77.1% were using them. We also found that only 61.8% washed their hands after attending every patient, 94.3% cleaned the area with a sterile swab before giving injections and only 35.7% of the labs/ wards/ operation theatres had three colored bags. Few (11.7%) of the workers have already been exposed to infectious blood samples and some (19.2%) are still not immunized against Hepatitis B. Conclusion: There is a need for improvement in the perception and practice of infection control measures among healthcare workers for both self and patients protection. They should also get themselves immunized against Hepatitis B and report accidental exposure to infectious samples to the infection control committee.

A profile of patients attending an Anti Retroviral Therapy (ART) centre at a tertiary care hospital in South India.

Background An estimated 2.5 million Indians are currently living with HIV. In 2004, the Indian government began providing free antiretroviral therapy (ART), through ART centers. This was conducted to assess the socio-demographic and clinical profile, opportunistic infection and treatment pattern of ART center attendees. Method