Awareness of over the counter antibiotics to combat antimicrobial resistance

Background: In India there is wide use of over the counter (OTC) antibiotics and unawareness of its harmful effects. In India dispensing antibiotics without prescription is a major contribution factor in development of antimicrobial resistance (AMR). The objectives of the present study were to evaluate awareness and proper use of OTC antibiotics in the community.Methods: Responses to a questionnaire covering various aspects on awareness and usage of OTC antibiotics were obtained from 100 families and 100 pharmacy shops in the community by second year MBBS students after permission from institutional ethical committee. The study period was from January 2019 to June 2019.Results: Among 100 responders 78% used OTC antibiotics for frequently reported illness like common cold (58%), body- ache (19%), fever (13%) and cough (10%). Most common reason for using OTC antibiotic is to avoid high consultation fees (64%).76% pharmacy dispense antibiotics without prescription. 60% pharmacy unaware of increase chance of developing resistance due to OTC antibiotics. 80% pharmacy maintain register book and were aware of laws and regulations of OTC prescription but still 70% dispense drugs due to fear of losing sales and profit. 50% pharmacy said they encourage patients to consult the physician and get the prescription. Most common antibiotic sold without prescription is amoxicillin (51%) and azithromycin (38%).Conclusions: We have identified unawareness among people about use and harmful effects of using OTC antibiotics. Also pharmacies are not following rules and regulations for OTC drugs. So our aim is to increase public knowledge of proper use and harmful effects of OTC antibiotics and help our global program to reduce AMR.

Comparative Assessment Of Subclinical Carotid Atherosclerosis In Hiv Patients And Healthy Controls By Ultrasonography & Its Correlation With Antiretroviral Therapy

Background: The study was planned to detect an association of HIV infection and sub-clinical atherosclerosis in the form of increased carotid intima-media thickness (IMT) Methods: 50 HIVpatients and 50 matched healthy controls were studied. The HIVpatients were further sub classified into those on ARTor not on ART. All of them underwent carotid doppler to identify subclinical atherosclerosis in the form of presence of either pathological intima-media thickness (IMT) or atherosclerotic plaque. Mean IMTwas calculated in various groups and the statistical analysis done. Results: The mean IMT in the test group (HIV), ART, Non ART, control groups was 0.746 mm (SD 0.181), 0.817 mm (SD 0.167), 0.58 mm (SD 0.068) ,0.572 mm (SD 0.101) respectively. There is significant difference in the mean IMT of HIV Vs control groups, ART Vs Non ART sub groups. There is no significant difference in mean IMTof Non ARTVs Control group. Conclusion: HIV patients have higher prevalence of subclinical atherosclerosis and significantly higher mean IMT as compared to Healthy controls. The prevalence of subclinical atherosclerosis is even higher in ARTtreated HIVpatients.

In Search Of Research- Cross Sectional Study To Assess Knowledge, Attitude And Practice Of Research In Undergraduate Medical Students.

Background & Objective of the study: Research in medical field is growing in leaps and bounds creating a new career option for the students. But there is poor understanding of research and its vastness among undergraduate students. There is dire need to expose undergraduate students to some basics of research activity. Prior to their orientation towards research there is a need to assess the knowledge, attitude and practice of research so as to pave way for developing new methodologies, strategies to foster student interest in research as an academic career and help create young researchers among this field.Objective of the study was to assess the knowledge,attitude and practice of research among medical undergraduate students.Materials & methods: A pre-validated questionnaire was prepared, provided to II Phase-II term MBBS students and their response was collected. Quantitative evaluation of the data acquired was done. Results: Response rate to the questionnaire was 84.8%. Though 81.2% students showed positive attitude towards research, mean score of research knowledge was 51.7% and mean score of research practice was only 11.9%. Conclusion: Undergraduate students have positive attitude towards research but their knowledge & practice of research is low. Further steps have to be undertaken to raise this bar of knowledge and practice of research among the undergraduate students.

A 36-year-old man with vomiting, pain abdomen, significant weight loss, hyponatremia, and hypoglycemia.

Diagnosis of Strongyloides stercoralis hyperinfection can be a challenge. The key to a timely diagnosis is to have a high index of suspicion. We present a rare case of a 36-year-old human immunodeficiency virus negative male patient, who was on multidrug therapy for lepromatous leprosy and was treated for type 2 lepra reactions with steroids in the past. The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission. A diagnosis of S. stercoralis hyperinfection with sepsis and multiorgan failure, adrenal hemorrhage, and syndrome of inappropriate antidiuretic hormone secretion was established on a postmortem examination.

Metaplastic Carcinoma of Breast - Squamous Variant.

Metaplastic carcinoma of breast is a rare neoplasm. Although it is a tumor of ductal type, the predominant component may have appearance other than the glandular pattern and usually runs an aggressive course.

Langerhans Cell Histiocytosis Presenting with Hypopigmented Macules.

Langerhans cell histiocytosis (LCH) is a complex disease characterized by proliferation of the Langerhans cells. The clinical course is variable and ranges from a solitary lytic bone lesion or skin lesion with complete remission to a multisystem disorder with possible lethal outcome. The diagnosis is suspected by clinical signs and symptoms and radiological features commonly in craniofacial bones and skin lesions. Diagnosis is confirmed by biopsy and immunohistochemical studies. We present case of a 8 year old child presenting with proptosis, diabetes insipidus and hypopigmented macules on chest and back showing bilateral distribution which is a rare presentation. Skin biopsy revealed the diagnosis of Langerhans cell histiocytosis.

Facio- Auriculo- Vertebral Sequence in association with Congenital Hypoparathyroidism.

Although, Facio-auriculo-vertebral sequence (FAVS) is a well recognized condition with cranio-facial, ocular and vertebral anomalies, extreme variability of expression is characteristic. Association of cardiac, CNS, lungs, kidneys and limb defects are described. We report a neonatal case with FAVS in association with congenital hypoparathyroidism.

Drug induced chronic acquired pure red cell aplasia in adolescent boy.

Acquired Pure red cell Aplasia (PRCA) is a disorder seen rarely in children and adolescents. Drugs like sodium valproate and carbamazepine have emerged as an important cause of acquired PRCA, when used for a long duration. Apart from the neurological side-effects, haematological side-effects in form of aplastic anemia and agranulocytosis are well-documented in carbamazepine therapy. The haematologic side-effects of carbamazepine, although not common, should nevertheless be borne in mind due to the serious, prolonged and sometimes even fatal consequences. Carbamazepine is a commonly prescribed drug in today’s scenario and it is important to be aware about its common and uncommon side-effects. We report a case of Carbamazepine induced pure red cell aplasia in an adolescent boy. Since, this drug induced PRCA is reversible if recognised early, it is worthwhile to be aware of this complication to prevent permanent morbidity due to generalised bone marrow hypoplasia.