Self-medication and its associated factors in Amdanga block of West Bengal

Background: The WHO defines the use of medications without prior medical consultation regarding indication, dosage and duration of treatment as self-medication. The practice is a global problem. Aims and Objectives: The study was conducted to describe the care seeking behavior of rural self-medicators living in Amdanga Block of West Bengal and to assess the belief in medicines by the self-medicators. Material & Methods: A descriptive cross-sectional study was conducted by interviewing with a pretested semi-structured questionnaire on 665 self-medicators out of 1740 adults who were interviewed in 80 villages of Amdanga Block, West Bengal. A three-stage sampling method was used to reach the study population. A three month recall on self-medication practice was considered operationalizing the “pull” and “push” factors of self-medicators using a Pshycho-social framework. The variables were Socio-demographic factors, Care Seeking Behaviors, Health System related factors, Belief in Medicines according to the framework. Results: The prevalence of self-medication was found to be 38.2%. 63% of the study subjects were female and 56.3% had a literacy status of middle school and above. 54.4% relied on their old prescription for self-medication. 68.7% had an initial choice to consult a doctor but later self-medicated of whom 53.2% changed their choice due to monetary and transport issues while 38.5% thought of self-medication considering their disease was mild in nature. Conclusion: Awareness and health education can link rural subjects with primary care facility and right decisions on care can be provided.

The structure of the kidneys in cholera

(1) Discrepancy in the findings of previous workers regarding the structural changes of kidney in cholera was presumably due to inadequate attention paid to correlate structural changes with the (a) stage of the disease (b) therapy received (c) autolytic changes due to inevitable delay in routine autopsy studies and fixation of specimen. (2) Controlled work to eliminate the variable factors showed that (a) the structural patterns varied at different stages of the disease e.g. (i) shock of 8-22 hours duration (ii) shock of 24-42 hours duration (iii) uraemia(5-9 days duration) (b) the pathology of kidney in the shock (8-22 hours duration) of cholera showed only congestion of the glomerulus and the tubules. The tubular degeneration started in the shock of 24-42 hours duration and was very prominent in the cases dying of uraemia (5-9 days). (3) This degeneration(in ii and iii) was widespread and of varying degree depending on the stage of the disease, affecting all parts of the tubles and was neither predominating in the cortex nor in the lower nephron. The pathology thus was of the same nature of acute renal failure of other extra-renal origin.