ABSTRACT
The principles of bioethics have been identified as important requirements for training basic medical doctors. Till now, various modalities have been used for teaching bioethics, such as lectures, followed by a small case-based discussion, case vignettes or debates among students. For effective teaching–learning of bioethics, it is necessary to integrate theory and practice rather than merely teach theoretical constructs without helping the students translate those constructs into practice. Classroom teaching can focus on the theoretical knowledge of professional relationships, patient–doctor relationships, issues at the beginning and end of life, reproductive technologies, etc. However, a better learning environment can be created through an experiencebased approach to complement lectures and facilitate successful teaching. Engaging students in reflective dialogue with their peers would allow them to refine their ideas with respect to learning ethics. It can help in the development both of the cognitive and affective domains of the teaching of bioethics. Real-life narratives by the interns, when used as case or situation analysis models for a particular ethical issue, can enhance other students’ insight and give them a moral boost. Doing this can change the classroom atmosphere, enhance motivation, improve the students’ aptitude and improve their attitude towards learning bioethics. Involving the students in this manner can prove to be a sustainable way of achieving the goal of deep reflective learning of bioethics and can serve as a new technique for maintaining the interest of students as well as teachers.
ABSTRACT
The present study aims at comparing the prescribing pattern of antihypertensive drugs in essential hypertension with specific co-morbid conditions with JNC-VII and WHO-ISH guidelines. Adult patients of both sex, who were attending medicine OPD of Shri Krishna Hospital, Karamsad, Gujarat since last 6 months and being prescribed antihypertensive drug/s for hypertension, were selected for the study. Hypertensive patients with co- morbities diabetes mellitus, ischemic heart diseases, congestive heart failure, and chronic renal diseases were included in the study. Adherence to JNC-VII guideline and WHO-ISH guidelines with respect to prescribing antihypertensive drugs in patients with diabetes mellitus were found to be 97% and 40.81% respectively, while it was found to be 72.27% to both the guidelines in patients with IHD. Similarly in cases of hypertension with CHF, adherence to prescribing antihypertensive were found to be 93.62% and 38.30% respectively, whereas for CKD patients, adherence to both guidelines was found to be same i.e. 33.33%. There is need of following such authentic guidelines in managing hypertension like chronic disease since these guidelines are based on various clinical trials and successful attainment of target BP in patients will be much easier by implementing them.
ABSTRACT
Background: The misuse of non-prescription drugs amongst students has become a serious problem. The youth is especially exposed to the media and the increased advertising of pharmaceuticals poses a larger threat to the young population. There is a paucity of studies on self-medication among medical students. Medical students may differ from the general population because they are exposed to knowledge about diseases and drugs. Aims & Objective: To determine the knowledge, attitude and practice of self-medication among medical students and to compare impact of pharmacology teaching among them. Material and Methods: This study was questionnaire based exploratory study. A self-developed questionnaire consisting of both open-ended and close-ended questions were prepared and given to fill up to students of first and second year medical students. Data was analyzed and associations were tested using the Chi square test. The results expressed as counts and percentages. Results: Out of 157 respondents, 78 were of first year and 79 were of second year. Among first year students 40 and 38, among second year students 58 and 21 were male and female respectively. Among first year students 21(26.92%) had knowledge of generic name, 40(51.28%) had knowledge of side effects and 72(92.33%) had knowledge of expiry date. Figure of knowledge among second year students were 70(88.6%), 72(91.13%) and 76(96.2%) respectively. Attitude wise 60(76.92%) of first year and 53(67.08%) of second year students believe in Ayurvedic/homeopathic medicines. 50(64.1%) of first year and 59(74.68%) of second year students had felt the necessity of medical knowledge towards self-medication. Practice wise 66(84.61%) of first year and 76(96.2%) of second year students had taken self-medication in last 6 months. Conclusion: This study shows that second year students tend to have greater knowledge of appropriate self-medication, have a more confident as well as concerned attitude towards self-medication, and tend to practice self-medication more often and appropriately.
ABSTRACT
Background: Drug utilization studies are powerful exploratory tools to ascertain the role of drugs in society. They create a sound sociomedical and health economic basis for healthcare decision making. The study was aimed to find out the changing pattern of prescribing the antidiabetic agents in patients suffering from diabetes mellitus type 1 and 2. Methods: It was a cross sectional study done on 200 patients suffering from type 1 and 2diabetes. Indoor patients and diabetes mellitus due to secondary cause were excluded. Each patient was followed up over a period of 1 year and the analysis of the prescriptions was done during that period. At end of study only 129 patients could be included for analysis. Results: In this study the maximal change in medicine was with pioglitazone which was discontinued as a 1st change in 6.2% of patients followed by metformin [5.4%], insulin [4.6%], and glipizide [3.8%]. The drug most commonly added as a first change was glipizide [11.6%] followed by metformin [10.0%] and pioglitazone [7.7%]. In order of 2nd change the most common drug discontinued was insulin [4.6%] followed by pioglitazone [3.8%] whereas drug commonly added as second change was insulin [2.3%] followed by glipizide [1.5%] and pioglitazone [1.5%]. In our cross sectional study average onset of 1st change was found to be at 4.38±2.75 months for discontinuation of drug and 3.75±2.42 months in adding the drugs. Conclusions: Due to lack of certain records, it is envisaged that the change of medicine both discontinuation as well as addition was done because of blood glucose control, cost factor [in case of pioglitazone] as well as patient’s compliance.
ABSTRACT
Atorvastatin, being one of the most commonly used antihyperlipidemic agents, is prescribed frequently by physicians all over the world but only a few data is available stating its effect in different ethnic population, more so from this part of India. The present study was designed focusing mainly on local population and was planned to determine plasma level of atorvastatin 10 mg and its effect on lipid profile in newly diagnosed hyperlipidemic patients attending Medical OPD of Shri Krishna Hospital, Karamsad (Gujarat). Study-I was carried out in 6 healthy volunteers to determine tmax after single dose of atorvastatin 10 mg under fasting conditions, on the basis of which Study-II was conducted in 15 patients, collecting blood samples at a particular time (i.e tmax of Study-I) after administration of atorvastatin 10 mg/day on day 1 as well as on the last day after 8 weeks of treatment. The plasma concentrations were determined by RP-HPLC system. Atorvastatin 10 mg/day for 8 weeks with a plasma level range (7.45, 12.08) ng/mL significantly (P<0.05) reduced all the parameters of lipid profile from the study population. The mean decrease in HDL-C triggers a question on the effect of atorvastatin on HDL-C, which requires further study on a larger population of our country.