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Institute
The practice, attitude, and knowledge of complementary and alternative medicine in Mumbai, India
(2020)
Background: In the recent times, there has been a resurging interest in the use of complementary and alternative medicine (CAM) in India. The present study was conducted to examine the prevalence of CAM use in Mumbai, the knowledge and attitude regarding CAM regarding its safety and efficacy and the reasons for the use of CAM.
Methods: A cross-sectional study was conducted among the general population of Mumbai and its adjoining regions during January-July 2020. 205 residents participated in the study and were asked to fill a pretested questionnaire. The collected data was analyzed using IBM SPSS version 23.
Results: Out of the 205 responses, 163 (79.51%) agreed to have used CAM at least once in their life. Of these, 108 (52.68%) respondents used Ayurveda and 105 (51.21%) used homeopathy. 60 (36.81%) of the respondents practicing CAM used it for common gastrointestinal (GIT)-related disorder with a 100% recovery rate, 125 (76.67%) for infectious diseases with a 93.6% recovery rate. 99 (60.74%) of the respondents preferring CAM for its safety profile, 68 (41.72%) believed that CAM is time tested and thus is efficacious. An integrative approach was suggested by 118 (57.56%) of all the respondents.
Conclusions: There is a disparity between the high prevalence in the use of CAM and its knowledge. However, a general consensus suggests that CAM is efficacious and is practiced for various indications.
Background: Concerns about practice of self-medication (SM) world across are based on associated risks such as adverse reactions, disease masking, increased morbidity, wastage of resources and antibiotic resistance. SM is likely to differ between rural and urban areas of India. Systematically retrieved evidence on these differences are required in order to design targeted measures for improvement. Methods: We conducted a cross sectional study among the general population in urban (Matunga) and rural (Tala) areas of Maharashtra, India to explore SM practices and its associated factors. Face to face interviews were conducted using the validated study questionnaire. Data was analyzed by using descriptive and analytical statistical methods. Results: A total of 1523 inhabitants from 462 households were interviewed between [June/2015] and [August /2015], 778 (51%) of them in rural and 745 (49%) in urban areas. Overall self-medication prevalence was 29.1% (urban; 51.5%, rural; 7.7%, OR 12.7, CI 9.4-17.2) in the study participants. Participants having chronic disease (OR: 3.15, CI: 2.07-4.79) and from urban areas (OR:15.38, CI:8.49-27.85) were more likely to self-medicate. Self-medication practices were characterized by having old prescription (41.6%) as the main reason, fever (39.4%) as top indication and NSAIDs (Non-Steroidal Anti Inflammatory Agents) as the most self-medicated category of drugs (40.7%). Conclusions: The present study documented that the prevalence of self-medication is associated with place of residence, and health status of the study participants. Self-medication is still a major issue in western Maharashtra, India and is majorly an urban phenomenon. Status of implementation of existing regulations should be reconsidered.
Background: Self-medication, practiced globally is an important public health problem. Research studies have indicated inappropriate self‐medication results in adverse drug reactions, disease masking, antibiotic resistance and wastage of healthcare resources. The objectives of the study were to explore overall self-medication and antibiotic self-medication prevalence among students of university students in Karachi, Pakistan along with probable reasons, indications, and sources of advice for self-medication. Methods: A descriptive, cross-sectional, questionnaire-based study was carried out among students from university of Karachi, Pakistan during the time period of September to November 2016. Pretested questionnaire was distributed to 320 students, collected data was analyzed using IBM SPSS version 24. Results: From 320 students, 311 (83 male and 228 female) students participated in the study giving a response rate of 97%. Prevalence of self-medication was 66%. Belonging to higher monthly family income group was associated with likelihood of self-medication. Antibiotic self-medication prevalence was 39%. Lack of time (39%), and old prescription (35%) were the main reasons for self-medication. Pharmacy shop (75%) was the main source for self-medication. In case of antibiotics, 44% students changed the dosage of antibiotic and 50% students stopped antibiotics after the disappearance of the symptoms. Conclusions: Antibiotic self-medication (39%) and self-medication with other drugs among university students of Karachi is a worrisome problem. Our findings highlight the need for planning interventions to promote the judicious use of general medicines as well as that of antibiotics.
Background: The mission of the pharmacy profession is to improve public health through ensuring safe, effective, and appropriate use of medications. Population health management (PHP) is a process wherein opportunities are identified to improve the quality of health care delivered and thereby, promote better health outcomes for patients.
Rationale: As concept of PHP is extremely important in today’s context, it is helpful to integrate data related to pharmacist in population health management practices. Authors conducted a systematic review of the literature on role of pharmacist in population health management practices. Method: We conducted a systematic review of the literature on literature on role of pharmacist in population health management practices by searching, PubMed Medline database using the following combination of keywords – pharmacist, population health. Truncation was used to ensure retrieval of all possible variations of search terms. The search was limited to articles published between 1st January 2015 and 31st December 2019, human studies and English language.
Results: Initial search resulted in a total of 281 studies, title abstract review to remove irrelevant studies resulted in 256 studies. Yearly trend showed that number of publications are decreasing. Highest number of publications were from Europe (47; 18%) and 29 publications (11%) discussed role of pharmacist in population health management of subjects in the age group of 10 to 20 years. Twenty five publications mentioned health management was done in the community settings. Advice on the lifestyle was mentioned in 242 (96%) and 10 (4%) publications offered advice about drugs during the health management. Pharmacists played important roles in population health management for e.g. as care provider in exploring the challenges faced in clinics for management of Type 2 DM. Pharmacists played an important role in increasing the quality of life of patients.
Discussion: Population health management concept has evolved steadily over the past few decades and is now contributing to the ‘patient care journey’ at all stages. There were 24 (9%) publications from India. Specially designed and implemented Pharm D program would play a major role in Indian health care system in future. This will give an opportunity to pharmacists to work more prominently in Indian health care system.
Conclusion: Authors are of the opinion that this is the first review encompassing the topic of pharmacist and population health management in the global context. It is clear that there is a global trend of moving towards involvement of pharmacist in healthcare management. This enables pharmacists to assume an expanded role and at same time it necessitates reforms in pharmacy education and practice.
Nanotechnology is emerging as one of the key technologies of the 21st century and is expected to enable developments across a wide range of sectors that can benefit citizens. Nanomedicine is an application of nanotechnology in the areas of healthcare, disease diagnosis, treatment and prevention of disease. Nanomedicines pose problem of nanotoxicity related to factors like size, shape, specific surface area, surface morphology, and crystallinity. Currently, nanomedicines are regulated as medicinal products or as medical devices and there is no specific regulatory framework for nanotechnology-based products neither in the EU nor in the USA. This review presents a scheme for classification and regulatory approval process for nanotechnology based medicines.
The world health organization defines musculoskeletal disorder (MSD) as “a disorder of muscles, tendons, peripheral vascular system not directly resulting from an acute or instantaneous event.1 Work related MSDs are one of the most important occupational hazards.1 Among many other occupations, dentistry is a highly demanding profession that requires good visual acuity, hearing, depth perception, psychomotor skills, manual dexterity, and ability to maintain occupational postures over long periods.
Background: Patient satisfaction is considered as an indicator of the healthcare quality. Information on patient satisfaction based on medical expertise of the physician, interpersonal skills, physician-patient interaction time, perception and needs of the patient allow policymakers to identify areas for improvement. Primary care services and healthcare structure differ between the countries. The present study was done to determine and analyze the determinants associated with patient satisfaction in India, Pakistan, Spain and USA.
Methods: This descriptive study was performed in January to August 2019 among students from Mumbai University, India, Dow University of Health Sciences, Karachi, Pakistan, University CEU Cardenal Herrera, Valencia, Spain, Texas State University, Texas, USA. On the basis of the eligibility criterion (those who gave a written informed consent and were registered students of respective university) 890 (India: 369, Pakistan: 128, Spain: 195, USA: 99) students were selected for the present study.
Results: India had almost similar male (49%) to female (51%) ratio of participants. For other 3 countries (PK, ES, US), female participant percentage was nearly 20% or even more as compared to male participants. Overall participant’s satisfaction score about medial expertise of the doctor were highest in India (71%) and were lowest in Spain (43%). Overall satisfaction score about time spent with doctor were highest for India (64%) and were lowest for Spain (41%). Overall satisfaction score about communication with doctor were highest for US (60%) and were lowest for PK (53%). Overall satisfaction score for medical care given by the doctor was lowest in PK (43%) and was highest in US (64%). Overall satisfaction about doctor, highest number of US (83%) and lowest number of PK (32%) participants were satisfied about medical interaction with doctors.
Conclusions: These multi-country findings can provide information for health policy making in India, Pakistan, Spain and USA. Although the average satisfaction per country, except Pakistan is more than 60%, the results suggest that there is ample room for improvement.
Background: Oral cancers (OC) are malignant lesions occurring in the oral cavity that include squamous cell carcinomas (SCC), salivary gland and odontogenic neoplasms. Even though it is the eighth most common malignancy globally but in Pakistan it is the second commonest type of cancer. Lack of awareness about ill-effects of preventable risk factors of oral cancer increases the burden of disease due to the associated high cost of treatment, permanent impairment and high mortality. Hence, awareness can be very helpful in prevention, control and early diagnosis of oral cancer.
Methods: A cross-sectional study was carried out among university students from Karachi, Pakistan during April to May 2018. Three hundred students were approached to participate in the study of which 277 agreed to participate. Pretested questionnaire was distributed and collected data was analysed using IBM SPSS version 23.
Results: There were 125 (45%) males and 152 (55%) females in the study and response rate was 94%. Sixty one percent (154/250) respondents correctly identified smoking, and tobacco chewing as possible causes of oral cancer. Almost one third (74%; 184/250) respondents correctly responded that oral cancer does not spread from person to person through touch or speaking. Sixty six percent (164/250) respondents believed that oral cancer is curable. Mean score of knowledge was higher in females (61%) than males (53%). Significantly higher number of females compared to male participants answered correctly to questions regarding cause of oral cancer, spread of disease and occurrence of oral cancer in AIDS patients.
Conclusions: Participants showed poor knowledge about oral cancer. Female participants showed better knowledge compared to male counterparts. Details about oral cancer should be incorporated in the university curriculum and periodic awareness programs should be organized for students.
Background: Oral cancer is among the top three types of cancers in India. Severe alcoholism, use of tobacco in the form of cigarettes, smokeless tobacco, and betel nut chewing are the most common risk factors for oral cancer. Often individuals with pre cancer even notice the alterations, such as reduced mouth opening in oral submucous fibrosis (OSMF), but they are not aware about the causes and consequences of these changes. Awareness about causes and features of oral cancers can be very helpful in prevention, control and early diagnosis of oral cancer.
Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. Five hundred students were approached to participate in the study of which 400 agreed to participate. Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: There were 199 (49%) males and 201 (50%) females in the study and response rate was (80%). Respondents had good knowledge about oral cancer. Seventy four percent (268/362) respondents correctly identified smoking, and tobacco chewing as possible causes of oral cancer. Almost all (96%; 348/362) respondents correctly responded that oral cancer does not spread from person to person through touch or speaking. Seventy two percent (260/362) respondents believed that oral cancer is curable. Significantly higher number of male (98%) compared to female participants answered correctly to questions regarding spread of disease and occurrence of oral cancer in AIDS patients.
Conclusions: Participants showed good knowledge about oral cancer. Female participants showed lesser knowledge compared to male counterparts. Details about oral cancer should be incorporated in the undergraduate curriculum and periodic awareness programs should be organized for students.
Malnutrition is the condition in which the body does not get the right amount of proteins, vitamins, or other nutrients.1 The global prevalence of malnutrition was reported as 13% in 2015.2 The subregion of South Asia is especially known as a critical area for severe wasted children aged <5 years.3 In India, 38.4% of children aged <3 years are stunted, and 46% are underweight.4 Malnutrition can lead to mortality as well as disabilities and long-term consequences such as cognitive disabilities, less economic productivity, or diseases.