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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.
Knowledge and attitude towards voluntary blood donation among students from Mumbai University
(2018)
Background: Blood is scarce; its demand far outweighs the supply. In addition to limited supply, the issue of safety especially with regard to the risk of transfusion transmissible infection is also an issue of utmost concern especially in the developing countries. Blood transfusion services in India have gained special significance in recent years and forms a vital part of national health care system. Voluntary Non-Remunerated Blood Donation (VNRBD) is the safest of all types of blood donations. One of the potential sources that can be tapped for blood donation is the young and physically fit students from educational institutions across India. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May–June 2017. Two hundred and fifty students were approached to participate in the study of which 201 agreed to participate (males: 104; females: 97). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: High number of participants agreed about encouraging general public about voluntary blood donation (96%; 193/201), lack of awareness about VBD in general public (82%; 164/201). But not a single participant was able to respond to the knowledge part of the questionnaire with 100% accuracy. Almost all the participants had correct knowledge about blood groups (98%; 196/201) and blood matching need (195/201; 97%). Conclusions: Participants showed good attitude but demonstrated poor knowledge about voluntary blood donation. Details about blood donation should be incorporated in the undergraduate curriculum and periodic awareness programs should be organized for students.
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: 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.
Background: Human papillomavirus (HPV) is a common sexually transmitted infection (STI) that may cause cervical cancer and other malignancies including those of the vulva, anus, vagina, penis, head and neck. In most Asian countries including India, cervical cancer is the second most common cancer in women. Awareness about HPV and cervical cancer, use of vaccines can be very helpful in prevention, control and early diagnosis of cervical cancer. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May - June 2017. Two hundred students were approached to participate in the study of which 142 were selected to participate (males: 54; females: 88). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: Participants had fair knowledge (61% average) about HPV, whereas knowledge about symptoms, prevention and spread of HPV was very poor i.e. 18%. Knowledge about HPV vaccine was 50% and 78% participants had positive attitude for HPV vaccine. Conclusions: This study showed the lacunas in the pharmacy curriculum and urgent need to create awareness of HPV among bachelor of pharmacy students from Mumbai University.
Background: Epilepsy is a chronic disorder of the brain that affects people worldwide. The overall prevalence (3.0-11.9 / 1,000) and incidence (0.2-0.6/1,000) of epilepsy in India are comparable to the rates of high-income countries. The high prevalence of negative attitudes towards epilepsy has been highlighted by several studies. Pharmacy students represent a better-educated section of society regarding drugs and have the potential to create awareness, and influence attitudes towards the disease. Thus, it is important that they have the appropriate and updated knowledge and appropriate attitude towards epilepsy and antiepileptic drugs. Objective of the present study was to determine the Mumbai University pharmacy student’s awareness about epilepsy, so as to know the kind of education and awareness strategies that would be applicable to them.
Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. Two hundred and fifty students were approached to participate in the study of which 213 agreed to participate (males: 107; females: 106). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: Response rate for this study was 85.2% (213/250). Ninety six percent (204/213) of the participants had heard or read about epilepsy. Overall knowledge was poor (40.2%) and attitude was fair (75.3%). None of the participants were aware about recent research regarding hereditary nature of epilepsy. Only 2 (0.98%) students were aware how to perform the first aid in epilepsy. Only 6.8% participants felt that epileptics should participate in sports.
Conclusions: The findings of this study show that, even with extensive curriculum covering diseases, drugs and relevant laws of land, the knowledge and attitude scores were low. There is a need to have focused education and campaigns to increase the knowledge and attitude towards epilepsy.
Background: Pharmacovigilance (PV); also known as drug safety surveillance, is the science of enhancing patient care and patient safety regarding the use of medicines by collecting, monitoring, assessing, and evaluating information from healthcare providers and patients. Pharmacists are pivotal players in adverse drug event (ADE) monitoring and reporting. However, most pharmacists are unaware or not knowledgeable about the guidelines used by their respective countries’ drug regulatory bodies. It is the need of the hour to train pharmacy students on the concept of pharmacovigilance.
Methods: A cross-sectional study was carried out among pharmacy students from Mumbai University, India during May-June 2017. On the basis of the eligibility criterion 352 students were selected for the present study. Four hundred students were approached to participate in the study of which 201 agreed to participate (males: 179; females: 173). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: Overall pharmacovigilance knowledge (44%) and perception (58%) was low among the participants of the present study. Seventy four percent of the participants felt that adverse drug reaction (ADR) reporting should be made compulsory for healthcare professionals. And only 21% agreed that the topic of Pharmacovigilance is well covered in pharmacy curriculum.
Conclusions: Pharmacy council of India, pharmacy teacher’s association and respective pharmacy college should take necessary steps to increase the knowledge and create awareness regarding pharmacovigilance and adverse drug reaction reporting among pharmacy students.
Objective: To determine the burden and factors associated with post-stroke depression in East central Nigeria.
Method: We carried out this cross-sectional study of 50 stroke survivors (mean age=54.8 ± 8.8 years), at the physiotherapy Department of the University of Nigeria Teaching Hospital, Enugu. Data were collected using Becks Depression Inventory , it was analyzed using Z-scores, Chi-square test and univariate logistic regression.
Results: PSD was more common in females (45.45%); middle-age(60%) adults(27-36/47-56 years respectively); living with spouse (45%); left cerebral lesions (40.74%). Self-employed and unemployed (66.67%), respectively. Age was significantly associated with depression (p=0.03), and was related to the risk ofOR3.7 (95% CI 1.1-12.0 )
Conclusion: Age could be a risk factor for PSD, which was more prevalent in the elderly than young/middle-age adults, female gender, left cerebral lesion, complications, cold case; those living with a spouse, self-employed and unemployed.
A systematic review of the literature on survey questionnaires to assess self-medication practices
(2017)
Self-medication is of great public health importance as it often bypasses regulatory mechanisms to assure quality of health care. Nevertheless there are no established standards on how to assess self-medication. We therefore intended to systematically retrieve questionnaires and survey tools used to capture self-medication, with the aim to identify the scope of information investigated in this context and commonalities between the tools. We conducted a systematic review of the literature on questionnaires used for self-medication assessment by searching PubMed and Web of Science databases using the combinations of following keywords; self-medication, self-prescription, non-prescription, questionnaire. Truncation was used to ensure retrieval of all possible variations of search terms. The search was limited to articles published between 1st January 2000 and 31st December 2015, human studies and English language. Duplicate and irrelevant studies were excluded from the final review. A total of 158 studies were included in the review. Studies were from diverse geographical locations, most of the studies were from Nigeria 16 (10.1%) followed by India 10 (6.3%) and Iran 8 (5%). Forty-three studies (27.2%) focused on antibiotic self-medication. Majority of the studies (106; 67%) were done with adult populations. The components addressed by the questionnaires covered: reasons for self-medications in 147 (93%) studies, purchasing source in 136 (86%) studies, medical conditions to be treated in 153 (96.8%) studies, adverse events in 67 (42.4%) studies, use of prescribing information in 24 (15.1%) studies and antibiotic resistance awareness in 20 (46.5%) antibiotic studies. For 74 (46.8%) studies, survey questionnaires were self-administered and most studies (57; 36%) were done at homes of respondents. Thirty-seven (23.4%) studies did not report any recall period for self-medication practices. Study response rates varied from 17.9% to 100%, and while validity of the study questionnaire was reported for 100 (63.3%) studies, 15 (9.5%) studies reported reliability test of the study questionnaire. There is a large variety of questionnaires being used for investigating self-medication practices making comparability and meta-analyses very difficult. It is desirable to have a basic set of standardized survey questions on this topic to make available for future research groups in this field.
The present investigation was conducted to investigate the in-vitro activity of ethanolic extract of roots of Centaurea behens by using DPPH radical scavenging activity, nitric oxide radical scavenging activity, hydrogen peroxide radical scavenging activity, hydroxyl radical. Result suggests that the extract possess significant antioxidant activity as compared to the standard ascorbic acid and thus further in vivo investigation is required to evaluate the medicinal significance of the extract which can be used for assessing the possible therapeutic importance of the drug.
Background: Hand hygiene practices (HHP), as a critical component of infection prevention/control, were investigated among physiotherapists in an Ebola endemic region.
Method: A standardized instrument was administered to 44 randomly selected physiotherapists (23 males and 21 females), from three tertiary hospitals in Enugu, Nigeria. Fifteen participants (aged 22–59 years) participated in focus group discussions (FGDs) and comprised 19 participants in a subsequent laboratory study. After treatment, the palms/fingers of physiotherapists were swabbed and cultured, then incubated aerobically overnight at 37°C, and examined for microbial growths. An antibiogram of the bacterial isolates was obtained.
Results: The majority (34/77.3%) of physiotherapists were aware of the HHP protocol, yet only 15/44.1% rated self-compliance at 71–100%. FGDs identified forgetfulness/inadequate HHP materials/infrastructure as the major barriers to HHP. Staphylococcus aureus were the most prevalent organisms, prior to (8/53.33%) and after (4/26.67%) HPP, while Pseudomonas spp. were acquired thereafter. E. coli were the most antibiotic resistant microbes but were completely removed after HHP. Ciprofloxacin and streptomycin were the most effective antibiotics.
Conclusion: Poor implementation of HPP was observed due to inadequate materials/infrastructure/poor behavioral orientation. Possibly, some HPP materials were contaminated; hence, new microbes were acquired. Since HPP removed the most antibiotic resistant microbes, it might be more effective in infection control than antibiotic medication.
Background: Immunization is the most cost-effective intervention for infectious diseases which are the major cause of morbidity and mortality worldwide. There is a scarcity of information on the vaccination status of young adults and the role of socioeconomic conditions in India. Objectives: Present study explored the adult vaccination status and influence of income and education of parents on adult vaccination status in university students from Mumbai, India.
Methods: On the basis of the eligibility criterion 149 students were selected for the present study. A total of 8 vaccines namely Tdap/DTP, Varicella, MMR, Influenza, Pneumococcal, Hepatitis A, Hepatitis B and Meningococcal were included in this study for all the respondents. In addition to these vaccines, Human Papilloma Virus vaccine was also included for female respondents.
Results: There were total of 149 (75 male and 74 females) respondents with the mean age of 21.5 years. The top 3 immunizations were Td/Tdap (97.3%), MMR (66.4%) and Hepatitis B (55%) among the respondents. Only 4 (5.5%) female respondents have been immunized against the HPV. Conclusions: Td/Tdap (97.3%) and MMR (66.4%) coverage was in line with the recommendations. For all the other vaccines the coverage was low varying from 5.5% to 35.4%. The vaccination coverage was better in respondents with higher educated and higher income parents. We suggest that patient education, planning by government for the implementation of policy for adult vaccination and involvement of physicians are must for better adult vaccination coverage.
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 drugs we use to treat any condition – from an innocuous cough to a life-threatening cancer – are the outcome of painstaking human clinical trials. These trials are the only way to credibly determine the safety and efficacy of drugs. In recent years there has been a clear shift in clinical trial sites from core developed countries like USA, European countries to developing countries like India, China, South American countries. This shift is related to challenges and opportunities like costs of trials, recruitment issues, and regulatory challenges in developed vs. developing countries. Developing countries and developed countries have their unique disease burden patterns based on various parameters like but not limited to age, health care facilities, health insurance, sanitary conditions, environmental issues, education, nutrition
and GDP. Previous studies have reported that many of the important global diseases are not much explored in clinical trials and many published clinical trials have very less international health relevance. This study was aimed at finding the correlation between disease burdens, number of clinical trials done and trial success rates. We compared 2005 - 2010 Global Burden of Disease data for Germany, India and number of clinical trials from clinicaltrials.gov database done in the same period. Our findings indicated that there was a good correlation between the disease burden and clinical trials for Germany in 2005 and 2010. For India in 2005 there was a moderate positive correlation, 2010 data showed the improvement in India in terms of match between disease burden and clinical trials. But careful observation of the data shows still a need for more trials on Communicable, maternal, neonatal and nutritional disorders.
Background: Foodstuff traders operating from warehouses (FTFW) are potentially exposed to dangerous rodenticides/pesticides that may have adverse effects on cardiopulmonary function. Methods: 50 consenting male foodstuff traders, comprising 15 traders (21–63 years) operating outside warehouses and 35 FTFW (20–64 years), were randomly recruited at Ogbete Market, Enugu, in a cross-sectional observational study of spirometric and electrocardiographic parameters. 17 FTFW (21–57 years) participated in focus group discussions. Qualitative and quantitative data were analysed thematically and with independent t-test and Pearson correlation coefficient at p < 0.05, respectively. Results: Most FTFW experienced respiratory symptoms, especially dry cough (97,1%) and wheezing (31.4%) with significant reductions in forced vital capacity (FVC) (t = -2.654; p = 0.011), forced expiratory volume in one second (FEV1) (t = -2.240; p = 0.030), maximum expiratory flow rate (FEF200-1200) (t = -1.148; p = -0.047), and forced end-expiratory flow (FEF25-75) (t = -1.11; p = 0.007). The maximum mid-expiratory flow (FEF25-75) was marginally decreased (p > 0.05) with a significantly prolonged (p < 0.05) QTc interval. Conclusion: Allergic response was evident in the FTFW. Significant decrease in FVC may negatively impact lung flow rates and explains the marginal decrease in FEF25-75, which implies a relative limitation in airflow of peripheral/distal airways and elastic recoil of the lungs. This is consistent with obstructive pulmonary disease; a significant decrease in FEF75-85/FEV1 supports this conclusion. Significant decrease in FEF200-1200 indicates abnormalities in the large airways/larynx just as significantly prolonged ventricular repolarization suggests cardiac arrhythmias.
Hypertension is a serious global public health problem. It accounts for 10% of all deaths in India and is the leading noncommunicable disease.1 Recent studies have shown that the prevalence of hypertension is 25% in urban and 10% in rural people in India.2 It exerts a substantial public health burden on cardiovascular health status and health care systems in India.3 Antihypertensive treatment effectively reduces hypertension-related morbidity and mortality.1 The cost of medications has always been a barrier to effective treatment.
Diabetes is fast gaining the status of a potential epidemic in India, with >62 million individuals currently diagnosed with the disease.1 India currently faces an uncertain future in relation to the potential burden that diabetes may impose on the country. An estimated US$ 2.2 billion would be needed to sufficiently treat all cases of type 2 diabetes mellitus (T2DM) in India.2 Many interventions can reduce the burden of this disease. However, health care resources are limited; thus, interventions for diabetes treatment should be prioritized.
Immunization is the most cost-effective intervention for infectious diseases, which are the major cause of morbidity and mortality worldwide. Vaccines not only protect the individual who is vaccinated but also reduce the burden of infectious vaccine-preventable diseases for the entire community.
1 Adult vaccination is very important given that >25% of mortality is due to infectious diseases.
2 There is a scarcity of information on the vaccination status of young adults and the role of socioeconomic conditions in India.
The medical devices sector helps save lives by providing innovative health care solutions regarding diagnosis, prevention, monitoring, treatment, and alleviation. Medical devices are classified into 1 of 3 categories in the order of increasing risk: Class I, Class II, and Class III.1 Medical devices are distinguished from drugs for regulatory purposes based on mechanism of action. Unlike drugs, medical devices operate via physical or mechanical means and are not dependent on metabolism to accomplish their primary intended effect.
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.