Nithin Kumar

Perceptions and Practices of Self-Medication among Medical Students in Coastal South India

Self-medication is a common practice worldwide and the irrational use of drugs is a cause of concern. This study assessed the prevalence of self-medication among the medical students in South India. The data was analysed using SPSS version 11.5. A total of 440 students were included in the study. The prevalence of self-medication was 78.6%. A larger number of females were self-medicating (81.2%) than males (75.3%). The majority of the students self-medicated because of the illness being too trivial for consultation (70.5%). Antipyretics were most commonly self–medicated by the participants (74.8%). Only 47% of the participants opined that self-medication was a part of self-care and it needs to be encouraged. 39.3% of the participants perceived that the supply of medicine without prescription by the pharmacist can prevent the growing trend of self-medication. Easy availability and accessibility to health care facilities remains the cornerstone for reducing the practice of self-medication.

Analysis of fatal road traffic accidents in a coastal township of South India

Road traffic accidents (RTAs) are important causes of mortality and morbidity due to the increasing number of vehicles, changes in lifestyle and the risk behaviours among general population. With the aim of exploring various epidemiological characteristics of RTAs, this retrospective analysis of medico-legal autopsies was conducted between January 2005 and December 2009 in the Department of Forensic Medicine, Kasturba Medical College, Manipal in Karnataka, South India. The information was collected from post-mortem registers and inquest documents received from the investigating police officers. The collected information was analysed using SPSS version 11.0. Out of the 879 autopsies conducted during the study period, 39% were due to RTAs. Among the victims, 89.8% were males and 10.2% were females. The mean age of victims was 38.7 years, which was slightly higher in females compared to males. Most of the male victims belonged to the age group 20-29 years. The head injuries were responsible for nearly 3/4th of deaths followed by abdominal injuries (6.7%). The mean duration of survival following road traffic accident was 6-7 days. Occupants of motorized two wheelers (43%) and pedestrians (33%) were the most common victims of RTAs followed by occupants of light motor vehicles (LMVs). The most common offending agents in road traffic accidents were heavy motor vehicles (35.2%) followed by light motor vehicles (31.7%). In view of the above finding, it is apt to conclude that RTAs are important public health hazards and should be addressed through strengthening of emergency healthcare, stricter enforcement of traffic laws and health education.

Clinico-epidemiological profile of burn patients admitted in a tertiary care hospital in coastal South India.

Every year a substantial proportion of deaths in India occur due to burn injuries. Prolonged morbidity as well as temporary and permanent disability due to burns results in a heavy economic loss. The etiological factors of burn injuries vary considerably in different communities and regions and hence the need for detailed epidemiological studies to understand the problem status in different regions. This study was aimed to study the sociodemographic profile of burn patients and to evaluate the causes, manner, and place of occurrence of burns injuries along with its outcome. A registry-based retrospective study was conducted at a tertiary care hospital in coastal South India, and the medical records of all the patients admitted to the burns centre during the year 2009 were reviewed. The data were analyzed using SPSS version 11.5. A total of 101 burn patients were admitted during the study period. The burn patients were aged between 4 months and 80 years with a mean age of 32.11 (± 3.46) years. The overall male to female ratio was 0.83:1. Majority of the patients were Hindus and were married. Flame burns were the most common etiology for sustaining burns (82.2%). Most of the burn injuries were sustained at home (n = 81, 80.2%), and the manner was designated as accidental in 79.2% of the cases. The TBSA involvement in burns ranged from 5 to 100% and the mean TBSA was found to be 45.8 ± 24.7%. A higher TBSA involvement is associated with an increased risk of mortality and this association between TBSA and mortality was found to be statistically significant (P < .05). Mortality rate in our study was 40.9%. Septicemia (n = 24, 63.2%) was the most common cause of death followed by shock (n = 12, 31.6%). Higher mortality is found to be associated with female sex, suicides, and flame burns. This study identifies the epidemiological and clinical features associated with burn injuries in coastal South India. Majority of the burn victims in our study were married females of younger age group. Although the manner of sustaining burns was mostly accidental, females were proportionately more commonly the victims of suicides and homicides than males. Injuries and deaths due to burns are preventable, provided a community-specific preventive program is implemented with a strong educational component.

Profile of blood donors and reasons for deferral in coastal South India

BACKGROUND A blood transfusion is a life-saving procedure in many instances. An adequate supply of safe blood is ensured by exercising donor deferral criteria and screening for Transfusion Transmitted Infections (TTI). The aim of this paper is to study the profile of blood donors and reasons for donor deferral in coastal South India. METHOD The study was conducted at a tertiary care hospital in Mangalore. All those who donated between 1 January 2008 and 31 December 2008 were included in the study. Data was collected using a pre-tested semi-structured proforma and analysed using SPSS version 11.5. RESULTS Most of the donors were under the age of 25 (42.92%). Donors were predominantly male (95.20%). In terms of occupation, most subjects were students (28.01%) followed by businessmen (18.61%). Slightly more than three-quarters of the donors (77.20%) were replacement donors. The main reasons for deferral were consumption of medication in the past 72 hours (15.15%), hypertension (13.18%), a low haemoglobin level (12.34%) and alcohol intake in the past 72 hours (12.20%). Among the TTIs identified, most samples were positive for Hepatitis B surface Antigen - HBsAg (0.87%) or tested positive for Anti-Hepatitis C (HCV antibodies (0.36%). CONCLUSION From the study it was concluded that the majority of the donor population was young and educated. The reason for donation was mainly replacement rather than voluntary. This issue needs to be addressed by exercising proactive measures to increase the number of voluntary, nonremunerated, low-risk donors.

Self-care activities among patients with diabetes attending a tertiary care hospital in Mangalore Karnataka, India

Background: Increasing prevalence of diabetes in India is resulting in an epidemiological transition. The care of the people with diabetes is traditionally seen as doctor centered, but the concept of self-care of people with diabetes is a new domain and is proven beneficial. Aim: The aim was to determine the practice of self-care activities among people with diabetes attending a tertiary care hospital in Mangalore. Subjects and Methods: A facility-based cross-sectional study was conducted in Government Wenlock Hospital, Mangalore during September-October 2012. A total of 290 patients with >1-year duration of diabetes mellitus (DM) were asked to respond to summary diabetes self-care activities questionnaire after obtaining the consent from them. The statistical analysis was performed in terms of descriptive statistics and association between the variables was tested using Mann-Whitney U-test. Results: A healthy eating plan on a daily basis was followed by 45.9% (133/290) of the participants, daily exercises for 30 min were followed by 43.4% (126/290), and regular blood sugar monitoring was done by 76.6% (222/290). Regarding the adherence to oral hypoglycemic agents and insulin, daily adherence to medication was seen among 60.5% (155/256) and 66.9% (138/206) were found to be adherent to insulin injections on a daily basis. Conclusions: Self-care practices were found to be unsatisfactory in almost all aspects except for blood sugar monitoring and treatment adherence. As these practices are essential for prevention of complications and better quality-of -life, more efforts should be put to educate the people with diabetes.

Perceptions and attitudes towards organ donation among people seeking healthcare in tertiary care centers of coastal south India

Background: Organ transplantation is the most preferred treatment modality for end-stage organ diseases. The need for the transplants is higher than the availability. Prerequisites for the success of transplantation program include awareness and positive attitudes. Aim: To assess the perceptions and attitudes of the people seeking health care in tertiary care centers towards organ donation in Mangalore, India. Settings and Design: This cross-sectional study included 863 people seeking general healthcare as outpatients. Materials and Methods: Face to face interviews were carried out using pretested tools which included the socio demographic data. Data was analyzed using Statistical Package for Social Sciences version 11.5. Results: Overall, 59.6% participants showed the willingness to donate organs. Females (64.1%) and participants from upper socio economic status (62.7%) had higher willingness rates for organ donations. Hindus (63.6%) and Christians (63.3%) had higher willingness rates for organ donations than Muslims (38.2%). Also, 23.7% participants showed willingness to donate eyes and 33.6% wished to donate any organ after death. Most of the participants (67%) were aware that money should not be accepted for donating organs, and 58.1% were aware that it is an offence to accept any benefit for organ donations. Forty percent participants had perceived risks associated with organ donation. Regarding donor cards, 42.3% of the participants knew about it and 3.7% already possessed it. Conclusion: It is apparent from the study that though there was high level of awareness about organ donation, a high proportion of the participants did not have positive attitudes towards organ donation.

Profile of Substance Use among Patients Attending De-Addiction Centres in a Coastal City of Southern India

Drug dependence is still to be recognized in developing countries as a significant public health problem and literature on the magnitude of this problem is limited. The present research was planned to study the socio-demographic profile and the reasons for substance use among patients admitted at De-addiction centres in Mangalore, India. In this cross-sectional study, all the patients admitted at the De-addiction centres during the study period were interviewed. The data was analyzed and the results obtained were expressed in proportions. A total of 83 patients were included in the study, all of whom were males. A positive family history of substance use was evident in 63% of the respondents. The mean age of the study participants was 41.9 (SD±11.2) years and the mean age for starting substance use was 20.9 (SD±7.7) years. The most common substance used was alcohol (95.2%). Majority of the subjects (56.6%) cited peer pressure as a reason for initiating substance use. Our findings suggest that the initiation of substance use occurs during late teenage years and mostly due to peer pressure. Our observations point towards the vulnerability of younger age towards substance use and hence, it is proposed that the preventive health policies in this regard should be targeted specifically during teenage years.

Diabetic peripheral neuropathy and its determinants among patients attending a tertiary health care centre in Mangalore, India

Background The burden of diabetes mellitus (DM) is on the rise especially in developing countries like India. Due to its chronic nature DM tends to cause many debilitating complications and diabetic peripheral neuropathy (DPN) is one of them. The aim of this study is to determine the prevalence of DPN among patients attending a tertiary care hospital and to identify the determinants associated with it. Design and methods A cross sectional study was conducted in Government Wenlock Hospital, Mangalore (India), during January-February 2014. A total of 208 patients with >5 year duration of DM were asked to respond to the patient history version of Michigan Neuropathy Screening Instrument (MNSI) and examinations were conducted after obtaining consent from them. The statistical analysis was done in terms of descriptive statistics and association between variables was tested using logistic regression test. Results The prevalence of DPN using the MNSI history version and MNSI examination were found to be 18.3% and 32.2% respectively. The major determinants associated with DPN were found to be male gender (OR: 2.7, CI: 1.4-5.1, P=0.001), smoking (OR: 5.8, CI: 1.9-17.3, P=0.001) and age >40 years (OR: 2.7, CI: 1.2-5.8, P=0.011). Conclusions The burden of undetected DPN was found to be higher among diabetics, with an especially higher prevalence among males, smokers and those with long standing diabetes mellitus. Interventions in the form of early detection through routine screening, smoking cessation and regular follow up examinations would go a long way in reducing the burden of disability among diabetics and improve their quality of life significantly. Significance for public health The findings of the current research hold importance since diabetes is one of the leading causes of morbidity and mortality across the world. Due to its chronic nature and effects of hyperglycaemia, diabetes tends to be associated with many comorbidities, like peripheral neuropathy, nephropathy, retinopathy etc. The presence of diabetic peripheral neuropathy leads to a reduced quality of life among diabetic patients due to the trauma and consequent gangrenes andamputation. The concept of secondary prevention can be applied to the prevention of diabetic peripheral neuropathy using easy to apply screening tools and thus help in early diagnosis and treatment to reduce the burden of this debilitating illness.

Occupational Exposure to Needle Stick Injuries among Health Care Personnel in a Tertiary Care Hospital: A Cross Sectional Study

Background: Health care personnel are at increased risk of contracting blood borne pathogens due to their occupational exposure to blood and body fluids. According to the World Health Organization, out of 35 million health workers worldwide, about 3 million receive percutaneous exposures to blood borne pathogens each year. Objectives: 1) To know the extent of occupational exposure to needle stick injuries among health care personnel of tertiary care hospitals. 2) Assessing the relationship between occurrence of needle stick injuries with the work experience and awareness regarding universal precautions among health care personnel. Methods: A cross sectional study was conducted among health care personnel of three tertiary care teaching hospitals attached to a medical college in coastal south India. The data was collected from the health care personnel by using a self-administered, pre tested, semi structured questionnaire. Analysis was done by using SPSS Version 11.5. Results: Majority of the health care personnel (n=127, 67.2%) were aged between 25 and 45 years. More than half of the health care personnel (n=109, 58.1%) were doctors followed by staff nurses (n=62, 33.4) and hospital supportive staffs (n=18, 9.5%). Needle stick injuries was observed among 71.9% (n=136) of health care personnel. Majority of the needle stick injuries were observed among the health care personnel who had a work experience of five and more than five years and it was found to be statistically significant. Needle stick injuries were more among health care personnel who were unaware of universal precautions. Conclusions: The proportion of needle stick injuries was more among health care personnel and this can be reduced by training the workers regarding universal precautions and making sure that they are adhering to these norms.

Perceptions and practices regarding use of personal listening devices among medical students in coastal south India.

UNLABELLED Todays generation enjoys having music at their fingertips. This has led to an increase in the usage of personal listening devices (PLDs) over the past decade. There are significant concerns regarding harmful effects of PLD use. To find out the perception and practice of medical students regarding use of PLDs. Cross-sectional study was carried out in Mangalore, Coastal south India. Data were collected using a 31 item semi structured questionnaire that was distributed among 570 medical students, of which 485 completed questionnaire were received giving an overall response rate of 86.14%. The study was approved by the departmental review board. STATISTICAL ANALYSIS USED data were analyzed using SPSS Version 11.5, Chi-square test for association was used and P<0.05 was considered statistically significant. Of the total study participants, 83.1% of them used PLDs regularly, of whom 77.7% used it for more than 1 h a day. Overall, 18.0% of the study population was aware that prolonged use of PLDs could be harmful to their health. Majority of the study subjects (72.4%) felt that the safe duration of listening to PLDs is 3 to 5 h. Among the subjects using PLDs ≥ 1 h, 60.1% preferred ear phones and among those using PLDs <1 h, 44.1% preferred earphones. Overall, 12.4% experienced temporary hearing loss on usage of PLDs. The use of PLDs among the medical students is on the rise, and they should be made more aware of the harmful effects associated with its use.