A comparative study of knowledge, attitude, and practice of self-medication among medical and nursing students in a government medical college of Eastern India

Background: Self-medication is defined as use of medicines without a doctor’s prescription and is frequently practiced among students in medical and nursing colleges. The purpose of this study was to compare the knowledge, attitude and practice of self-medication between 2nd year medical and nursing students in a government medical college of West Bengal, India. Aims and Objectives: The objectives of the study were to assess the knowledge, attitude and practice of self-medication among 2nd year medical students and nursing students and to compare their differences if any. Materials and Methods: A cross-sectional, observational, and questionnaire based study conducted between two groups of students, medical, and nursing, who were interviewed with a prevalidated questionnaire. Demographic data and questions regarding knowledge, attitude, and practice of self-medication were included. Details and purpose of the study were explained to the students. The collected data were analyzed statistically and the comparison between the two groups was done. Results: A total of 260 students were interviewed, of whom 231 participants were selected involving 172 medical students and 59 nursing students. Although 89% of the students have practiced self-medication within the past 1 year, only 61% students agreed recommending self-treatment to others. Accordingly, there were significant differences among the two groups in terms of source of information, preference, frequency of practice, disadvantages, and drugs/drug groups taken for self-medication. Conclusion: Self-medication is a common form of health care with potential benefits and hazards. Our study suggests self-medication being employed more commonly by medical students than their nursing counterparts. Hence, it is very important to increase the awareness about the pros and cons of self-medication for both medical and nursing students to improve their knowledge, attitude, and practice and eventually to increase the awareness in the society.

Quality of life among geriatric population: A cross-sectional study in a rural area of Sepahijala District, Tripura

Background: Quality of life (QOL) among elderly is an important area of concern which reflects the health status and well-being of this vulnerable population. Objectives: The objective of this study is to find out different domains of QOL and its association with sociodemographic factors among geriatric population. Methods: A community-based cross-sectional study was done among 76 persons aged 60 years and above from August 2016 to October 2016 in rural areas of Madhupur, Sepahijala district, Tripura. The World Health Organization QOL-BREF scale was used and analysis was done using SPSS version 20.0 statistical software. P < 0.05 was considered as statistically significant. Results: The mean QOL score was maximum in social health domain (67.32 � 15.30), followed by environmental health (51.64 � 10.11), lowest was in psychological domain (44.29 � 11.50). Better physical health domain score was found among participants <70 years age. Psychological health was better among Hindu and persons from nuclear family and higher socioeconomic class, whereas male, illiterate, and businessman had better social relationship. Environmental domain score was significantly better among primary educated, businessman, and higher socioeconomic class people. Conclusion: The present study revealed social relationship domain had higher mean QOL score in comparison to other domains, but contrastingly psychological domain was affected worst in 搊ld age group.� Further research can be done to explore the factors affecting psychological domain.

Histological Patterns of Ovarian Neoplasms – A Five Year Experience in North-East India

Ovary is one of the common sites of neoplasm in females. They manifest in wide spectrum of clinical, morphological and histological features. Ovary is the second most common site of primary malignancy in female genital tract.

Histomorphological Spectrum of Splenectomy Specimens in a Tertiary Teaching Hospital:A Seven Year Study

Background: Spleen is the largest organ of the mononuclear phagocytic system and is involved in all systemic inflammations, generalized hematopoietic disorders, and many metabolic disturbances. Splenectomy is frequently indicated where diagnosis is already established and the purpose of surgery being largely therapeutic in nature. Objectives: The study aims to highlight the histomorphological patterns in the surgically resected splenectomy specimens received in our centre and to correlate with the clinical indications. Materials and Methods: This was a seven year study of all splenectomy specimens received at histopathology section of Department of Pathology in a tertiary care hospital. All the histopathology slides were reviewed by the authors and the microscopic findings were studied and correlated with clinical data. Results: Twenty two (22) spleen samples were received during the study period with a M:F=1: 1.2 . The age range was 2 years to 60 years. The highest number of splenectomy cases was in the age group of 11-20 years followed by 0-10 years age group. The majority of the cases of splenectomy were indicated for thalassemia (14 cases, i.e. 63.64% of all cases), followed by traumatic rupture and secondary malignancy with 2 cases each (9.09% cases each), one case each for splenic infarct, myelofibrosis, ITP and splenic tuberculosis. Conclusion: Thalassemia was proved to be the commonest indication of splenectomy, followed by traumatic rupture and secondary malignancy in the spleen. Larger studies are needed for better understanding of this important organ and unnecessary splenectomies may thus be avoided

Case Based Learning in Undergraduate Pathology A Study to Assess its Efficacy and Acceptability as Teaching-Learning Tool

Background: An innovative paradigm, of teaching-learning (TL) method, like Case Based Learning (CBL) in a paraclinical subject like Pathology is considered essential, which would bring about learning of pathological and clinical features of diseases in an integrated easy manner, resulting in growing of interest in undergraduate medical students to learn pathology with better retention of knowledge. Aim: To evaluate the efficacy of CBL as a TL method in Pathology and to assess perception of students and teachers to CBL. Materials and methods: Study involved 86 students from 2 nd professional MBBS course. Two common diseases viz. microcytic hypochromic anemia and pulmonary tuberculosis were taught in two phases respectively. Students were equally divided into two large groups of 43 each – Didactic lecture (DL) and CBL groups. DL group was taught with conventional DL by Pathology-faculties and CBL group was taught with CBL tool jointly by pathology and relevant clinical faculties. Teaching method was interchanged between large groups for two diseases. Pretest and post-test were conducted before and after intervention (DL/CBL) respectively. In addition, to test for knowledge retention one late post-test was also conducted in 2nd phase. Lastly, students’ and teachers’ feedbacks on perception to CBL were obtained

Synchronous occurrence of anaplastic, follicular and papillary carcinomas with follicular adenoma in thyroid gland.

Various combinations of thyroid carcinomas have been reported including those between different cancers of follicular cell origin and those between follicular and C-cell histogenesis. Accordingly, anaplastic carcinomas have been seen to coincide with simultaneous papillary and follicular cancers. We report a case of composite anaplastic and papillary cancer on one thyroid lobe with a follicular carcinoma in the other lobe in a female patient aged 64 years. The patient also had a separate and independent follicular adenoma in the same lobe as the composite anaplastic and papillary carcinoma. The papillary carcinoma was continuous with the anaplastic carcinoma. The findings were supported by immunohistochemistry. The patient was managed by a total thyroidectomy with bilateral modified radical neck dissection followed by chemotherapy. However, she died two months after surgery. The common follicular cell origin will explain the concurrent presence of all these cancers. This could result from the dedifferentiation of a pre-existing differentiated carcinoma.

Miller Fisher syndrome--an uncommon clinical presentation.

Miller Fisher syndrome is an uncommon disease and it is a variant of Guillain-Barre syndrome. Miller Fisher syndrome also has rarer variants. Combined features of classic Guillain-Barre syndrome and Miller Fisher syndrome are uncommon. Here we are reporting a case of Miller Fisher variant with Guillain-Barre syndrome overlap in which ataxia, are flexia, oculomotor disturbance and limb weakness occurred within few days.

Chemical characterization of the lipopolysaccharides from enteropathogenic Escherichia coli O142 and O158.

Lipopolysaccharides (LPS) from two enteropathogenic strains of E. coli O142 and O158 were isolated by hot phenol-water extraction procedure. Polyacrylamide gel electrophoretic pattern of the LPS showed the typical ladder like pattern of smooth type of LPS. The LPS of E. coli O158 was found to contain L-rhamnose, D-glucose and N-acetyl-D-galactosamine as major constituents together with D-galactose, N-acetyl-D-glucosamine, L-glycero-D-manno-heptose and 2-keto-3-deoxy-D-manno-octulosonic acid (KDO) whereas LPS from E. coli O142 contained L-rhamnose, N-acetyl-D-glucosamine and N-acetyl-D-galactosamine as major constituents together with D-glucose, D-galactose, N-acetyl-D-glucosamine, L-glycero-D-mannoheptose and 2-keto-3-deoxy-D-manno-octulosonic acid (KDO). LPS was degraded by mild acid hydrolysis to yield a degraded polysaccharide fraction and an insoluble lipid-A fraction. The main fatty acids of the lipid-A fraction of the LPS were C12:O, C14:O, and 3-OH C14:O for O158 strain whereas E. coli O142 lipid-A consisted of C12:O, C14:O, 3-OH C14:O, and C16:O. The degraded polysaccharide fraction on gel permeation chromatography gave a high moleculer weight O-chain fraction and a core oligosaccharide and a fraction containing degraded sugars. The chemical composition of LPS and its fragmented products are reported in this communication.

A study of the effects of pulsed electromagnetic field therapy with respect to serological grouping in rheumatoid arthritis.

The positive role of pulsed electromagnetic field (PEMF) therapy in rheumatoid arthritis (RA) is known. The differential role of serological status of patients in RA is also well known. This paper presents a study of the differential effects of PEMF therapy on the two serological groups of patients. The responses of the seropositive patients are found to be more subdued. Varying effects of the therapy in alleviating the different symptomatologies indicate that the rheumatoid factor (RF) is more resistant to PEMF.

Sialylmotifs of sialyltransferases.

The sialyl moiety of sialylated glycoconjugates expressed on the cell surface are increasingly recognized as the key determinants of various biological recognition events. The transfer of sialic acid to these glycoconjugates are catalyzed by sialyltransferases, a group of 15 or more Golgi enzymes. Cloning of three sialyltransferases from this laboratory, indicated for the first time, that these enzymes are type II membrane proteins and share the topological features common to other glycosyltransferases. However, unlike the other members of the glycosyltransferase family, these enzymes showed the presence of two conserve protein domains, termed 'sialylmotifs'. This unique feature was subsequently found to be present in all the sialyltransferases cloned to-date. The larger 'L-sialylmotif' consisting of 48-49 amino acids is present in the middle of the luminal catalytic domain and has, eight invariant residues, while the 'S-sialylmotif' present closer to the C-terminal end of the enzyme has two invariants among a stretch of 23 amino acids. The other not-so-invariant amino acids are also conserved and their replacement is limited. The functional role of these two sialylmotifs were investigated by single-point site-directed mutagenesis using Gal beta 1, 4GlcNAc alpha 2,6-sialyltransferase (ST6Gal I) as a model. Detailed kinetic analysis of the mutants indicated that the 'L-sialylmotif' contributes to the binding of the common donor substrate CMP-NeuAc, while the 'S-sialylmotif' contributes to the binding of both the donor and acceptor substrates.

Role of hypo-osmotic sperm swelling test in assisted reproduction.

Hypo-osmotic sperm swelling (HOS) profile is found to be a better predictor of the fertilisability in those husbands possessing subnormal semen parameters. The group where husband's HOS gradings were less than 60%, no one could conceive his fertile wife even after intra-uterine insemination (IUI) for 8 times. However, in the other group where the HOS values were greater than 60%, conception were registered in 6 oligospermic and 2 asthenospermic husbands after 2 to 8 IUI amongst 22 married couples. No conception occurred in any normal coital cycle. All the pregnancies were delivered by elective caesarean section (4 females and 3 males), their birth weights were 2.705 +/- 0.425 kg. One aborted spontaneously at 10 weeks' gestation. The emerging fact in this study is where the HOS values are below 60% the male fertility is reduced, the chances of conception are trivial but fecundity is relatively fair where HOS reading is greater than 60%. It is also a no risk and high benefit method to pick and choose subfertile husbands who are likely to conceive their fertile wives by assisted reproductive techniques.

Role of hyperphagia in structural changes of small intestine during lactation.

The present study was conducted to investigate the cause of the structural changes of small intestine during lactation in albino rats. Anatomical measurements (total length, total wet weight and total dry weight) and histological studies of small intestine were undertaken in virgin control rats, lactating control rats, lactating rats with restricted food intake and lactating rats with restricted litter size. Restriction of food intake prevented the growth of small intestine during lactation, while restriction of litter size had no effect. Results indicate that the structural changes in small intestine are due to work hypertrophy secondary to hyperphagia and not due to any hormonal factors.

Haemagglutinating property & cell surface hydrophobicity of Vibrio cholerae 0139.

Cell-associated haemagglutinating activity was detected in all the epidemic strains of V. cholerae 0139 and 01, isolated in different parts of the country, with erythrocytes from rabbit, rat, chicken and guinea pig. Sheep erythrocytes were unresponsive to both groups of strains. While D-mannose, alpha-methyl-D-mannoside, glucosamine, N-acetyl-D-glucosamine, thyroglobuline were effective inhibitors of the haemagglutinating activity of the V. cholerae 0139 and 01 strains, galactose and N-acetyl-D-galactosamine sensitive haemagglutinins (HAs) were detected in the V. cholerae 01 but not in the V. cholerae 0139 strains. The best medium for expression of HAs in V. cholerae 01 and 0139 strains were observed to be penassay broth and tryptic soy broth respectively. The expression of HA in V. cholerae 01 was stimulated by Ca++ and Fe in the growth medium unlike that of V. cholerae 0139 which remained unaffected by these ions.

Rapid purification of secretory acid proteinase from Candida albicans and its characterization.

Secretory acid proteinase from C. albicans was purified from culture supernatant to apparent homogeneity by ion-exchange chromatography. Two isozymes of the proteinase were resolved using a novel chromatofocusing method. The enzyme, which appears to be a glycoprotein, consists of a single polypeptide chain with glutamine at the N-terminus. Its molecular weight is about 45,000 and isoelectric point is pH 4.6. At pH 5, the proteinase is stable at 45 degrees C for at least 15 min. It has a broad substrate specificity. With BSA as a substrate, Km was determined to be 1.6 x 10(-4) M. The enzyme is inhibited by pepstatin and thus is a carboxyl proteinase. It undergoes autocatalytic digestion at or below pH 5.0. The kinetics of induction of proteinase by various proteins are also reported.

Non-organ specific & organ specific antibodies in rheumatoid arthritis.

Fifty patients of rheumatoid arthritis clinically diagnosed (by ARA criteria) were studied for both non-organ specific [rheumatoid factor (RF), anti-nuclear antibodies (ANA), extractable nuclear antibody (ENA), granulocyte specific anti-nuclear antibody (GS-ANA), anti-smooth muscle antibody (SMA) and anti-mitochondrial antibody (AMA)] and organ specific, [anti-adrenal (AAA), anti-islet cell (ICA), antithyroid antibody (ATA) and anti-parietal cell (PCA)] auto antibodies. RF was positive in 80 per cent of patients. ANA was positive in 44 per cent of patients, ENA in 62 per cent, SMA in 20 per cent, AMA in 18 per cent and GS-ANA in 68 per cent. Of the organ specific antibodies, PCA was demonstrable in 28 per cent of the patients and none of the other antibodies were present. Circumstantial evidence indicates that ANA and GS-ANA are not synonymous but independent, cross-reacting entities and the presence of both increase the sensitivity (94%) of diagnosis of RA.

Isolation, partial purification and pharmacodynamics of a slow contractile substance in the venom sac extract of the wasp Vespa cincta Fabr.

The venom of V. cincta contains acetylcholine (ACh), histamine and 5-hydroxytryptamine (5-HT). Blockers of these agonists did not block completely the hypotensive and smooth muscle contractile activity of venom. On smooth muscle, there was a residual slow contraction. The active substance which produced this slow contraction was separated by solvent extraction, gel filtration and TLC. The purified material (which has been provisionally designated "Vecikinin") lowered cat, rat and guinea pig blood pressure, increased amplitude of cardiac contraction, and increased capillary permeability. Vecikinin contracted several smooth muscle preparations (rat uterus, rat ascending colon, guinea pig ileum, guinea pig colon and rat ileum), while relaxing rat duodenum. Its contractile activity was not lost on boiling, but acid or alkali-boiling reduced its contractile activity. It was inactivated on incubation with chymotrypsin and carboxypeptidase but not with trypsin, pepsin or leucine aminopeptidase. It is a peptide, appears to be of low molecular weight, and could be distinguished from substance P, angiotensin, bradykinin and hornet or wasp kinin.

Effect of epinephrine on the in vitro biosynthesis of fibrinogen.

In an in vitro rat liver slice incubation system, the synthesis of fibrinogen, when measured by immunoprecipitation technique was stimulated in the presence of epinephrine. An increase in poly (A)+ RNA content of the liver slice was also observed after epinephrine treatment. This in vitro experiment demonstrated that epinephrine stimulated de novo synthesis of fibrinogen by acting directly on the liver.