ABSTRACT
Background: Tobacco use is a major preventable cause of morbidity and mortality. Tobacco usage among medical professionals should be reduced. It is important that they are aware regarding effects/ill effects of tobacco use, anti tobacco strategies, tobacco cessation technique to reduce tobacco usage among population. Authors undertook this study to understand tobacco use among medical students.Methods: Authors conducted cross sectional, descriptive study by collecting anonymous data of 414 undergraduate medical students of medical college, Jamnagar in predesigned forms. Data were analysed using MS-excel and graphpad prism. Authors used Fagerstrom test for nicotine dependence to assess nicotine dependence.Results: Tobacco users were 19.57%, among them 83.95% were smokers. Prevalence was higher in male (34.35% in male and 1.09% in female subgroup) and students with positive family history (36.81% in positive and 6.03% in negative family history subgroup). Current users were 7.73%. They were 8.20% in hosteller and 2.78% day scholar subgroups. Authors didn抰 find statistical significant association of medical education with habit. Leading causes of starting tobacco use were curiosity/recreational purpose (35.8%), peer group pressure (32.10%) and stress (25.93%). Most of current user had low nicotine dependence (73.33%).Conclusions: Tobacco use among medical students is a significant problem. Important factors affecting it are gender, family history, current living status, stress, peer group pressure, media influences. Authors recommend that special awareness programme and specific training regarding tobacco cessation should be given to medical students.
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Background: Infants and children constitute a large proportion of the population in developing countries. In Gujarat, studies on drug use patterns in the pediatric age group are lacking in the Saurashtra region hospitals. The objective was to study demographical information and the utilization pattern in the in patients of the pediatric ward. Methods: A cross-sectional, observational drug utilization study was carried out over a period of 6 months in 630 pediatric inpatients of the pediatric department of Guru Gobind Singh Hospital, Jamnagar, a tertiary care teaching hospital. Analyzed data included demographic details and drugs prescribed in respective patients. Results: Most commonly affected age group was 1-5 years, boys in 62.06% and girls in 37.94% and 40.16% were admitted in the pediatric ward. Acute gastroenteritis and pneumonia had the highest admission rate with 31.90% and 22.38%, respectively. The majority of children were prescribed 5-6 drugs. Ceftriaxone (64.92%) was the top most frequently prescribed antibiotic, followed by amoxicillin (49.21%). Prescribing drugs were mainly from essential drug list (64.44%) and by generic names (61.89%). Drugs prescribed orally in 66.10% and by injections in 33.90%. Conclusion: It is quite evident that significantly large number of children were from 1 to 5 year age group. The majority of the children were admitted in inpatients of the pediatric ward for acute gastroenteritis, followed by pneumonia and meningitis. Most frequently prescribed antibiotic group was cephalosporin, followed by penicillin group.
ABSTRACT
Background: Resistance of Plasmodium falciparum to antimalarial drugs is common in India. World Health Organization (WHO) recommends artemisinin based combination therapy (ACT) to counter the development of resistance in P. falciparum. WHO recommends that ideally antimalarial drug treatment policy or guidelines should be reviewed regularly and updated at least once every 24 months. In consideration to the above recommendation, we planned to conduct the following study. The objective was to determine the efficacy and safety of artesunate + sulphadoxine pyrimethamine (AS + SP) in patients with uncomplicated P. falciparum malaria. Methods: The study included 60 patients of uncomplicated P. falciparum. Each patient received AS + SP as per WHO guidelines. Diagnosis was confirmed by peripheral blood film. All patients were followed up on days 1, 3, 14, and 28 for detailed clinical and parasitological examination. Results: Of a total 60 patients, 55 patients were followed up for 28 days. Remaining 5 patients were lost in follow up. As per protocol analysis, 91% (50) of patients had demonstrated adequate clinical and parasitological response. Remaining 9% (5) had treatment failure in which 5.5% (3) had late parasitological failure and 3.6% (2) had late clinical failure. In our study, mean parasite clearance time was 45.2 ± 4.2 hrs. Conclusion: AS + SP is safe and effective drug for the treatment of uncomplicated falciparum malaria. However, the efficacy of this ACT needs to be carefully monitored periodically since treatment failure can occur due to resistance.
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Background: Epilepsy is “a condition characterized by recurrent (two or more) seizure, unprovoked by any immediate identifi ed cause.” The desired outcome of antiseizure drug (ASD) therapy is to be seizure-free throughout the rest of life. The objective was to study the utilization pattern and adverse drug reactions (ADRs) associated with the use of ASDs in pediatric outpatients in epilepsy clinic. Methods: This cross-sectional, observational and single center study was carried out over a period of 1 year in 430 pediatric patients. Analyzed data included demographic details and drugs prescribed in respective seizure types along with ADRs due to ASDs. Results: In a total 430 patients analyzed, seizure were most commonly observed in boys (69.8%) in 6-10 year of age (45.3%), with a positive family history in (16%), with no specifi c cause of seizure in (71.6%), with most common type was focal seizure in (62.3%), which was mainly treated with carbamazepine (73.8%). Most common ADR was irritability (32.2%) with Valproate being main drug. 87.3% ADRs were in “ possible” as per World Health Organization causality assessment scale, 94.9% ADRs were “mild” as per Hartwig and Siegel severity assessment scale and 98.3% ADRs were “preventable” as per Schumock and Thornton preventability scale. Conclusion: Focal seizure was most common type of seizure observed mainly in boys of 6-10 year with carbamazepine as mainly prescribed drug. Use of appropriate ASDs in the majority of patients as per guidelines, has decreased number of ADRs in our study. Prescribing drugs were mainly from essential drug list and by generic names.
ABSTRACT
Background: Vaccination is an essential component of the public health programs and among most cost effective medical intervention. Vaccines like other pharmaceutical product are not entirely risk free; while most known side effects are mild and non-serious. But some vaccines have been associated with very rare but serious side effect. So, there is a need of a surveillance program to monitor and record such events. Aims & Objective: To detect adverse events following immunizations (AEFI) in children and find vaccine responsible for them. Material and Methods: A one year, prospective, vaccine safety study was undertaken in 2011 covering a pediatric population who were administered vaccines. A two-phase telephone survey of all patients was conducted, comprising of an initial call at 1 week and a follow-up call at 30 days after the vaccine administration date. All AEFI were recorded in Vaccine Adverse Event Reporting System (VAERS) form. Results: Of a total sample of 4320 children, ranging in age from 0 to 14 years, 10110 vaccine doses were given. Each child received 2.34 vaccines on an average. Out of 4320 children, 899 children (20.8%) suffered 1003 AEFI. The most frequent types of adverse reactions to vaccines were fever (34.33 per 1000 doses), excessive crying (30.95 per 1000 doses) and injection site swelling (18.57 per 1000 doses). AEFI rate per 1000 doses was 99.2%. Conclusion: Most of the adverse events reported were mild and non-serious. Establishment of national AEFI database can be a worthy long term goal in Indian context.