A comparative study on child birth experience of mothers at tertiary care hospital

Background: Women's childbirth experience can profoundly impact their overall well-being and health. Evaluating maternal satisfaction with childbirth services is essential for assessing the quality of healthcare. Childbirth satisfaction is multifaceted, influenced by antepartum, intrapartum, and postpartum factors. Midwives play a pivotal role in guiding women's birthing choices. Aim was to assess the impact of antepartum, intrapartum, and postpartum interventions on maternal satisfaction in a tertiary care teaching hospital.Methods: A prospective cohort study was conducted with 126 women divided into two groups: Group A (Booked) and Group B (Unbooked). Group A received comprehensive care, including antenatal exercises, breastfeeding counselling, education on alternative birthing positions, and non-pharmacological pain management during labor, leading to deliveries in alternative positions. Group B received standard antenatal care, delivered in the conventional lithotomy position, and used pharmacological pain management.Results: Midwife-led counselling during antepartum, intrapartum, and postpartum phases positively influenced childbirth experiences. Group A showed lower postpartum pain scores, quicker initiation of breastfeeding, reduced episiotomy needs, shorter second-stage labour, and higher antepartum satisfaction compared to Group B.Conclusions: Among healthy pregnant women, midwife-led care, including antenatal counselling, alternative birthing positions, exercises, and non-pharmacological pain management, correlated with shorter labor duration, decreased pain levels, higher satisfaction, reduced episiotomy rates, earlier breastfeeding initiation, and better APGAR scores. This underscores the positive impact of midwives in delivering patient-centered care and enhancing overall care quality.

Correlation of lipid profile of infertile men with abnormal semen parameters

Background: Male’s inability to impregnate a fertile female is referred as male factor infertility. It accounts for 40-50% of infertile couples and affects almost 7% of all men. Male comorbidities and conditions, which negatively affect men’s health, have been repeatedly associated with impaired reproductive functioning. Cholesterol is the main substrate for steroid synthesis and it plays crucial role in formation of sperm plasma membrane and thus in spermatogenesis, highlighting the role of serum lipids in male fecundity. Purpose of the study is to evaluate correlation lipid profile of male partners with abnormal semen parameters in infertile couples.Methods: A cross sectional study was carried out in the infertility clinic of a tertiary care hospital for over 18 months and 151 infertile men with abnormal semen parameters (as per WHO 2010 criteria) were enrolled. Evaluation of lipid profile was done and its relationship with abnormal semen parameters was analyzed.Results: Significant positive correlation was seen between LDL and Triglyceride with sperm concentration and total sperm count. However, significant negative correlation was seen between Triglyceride and sperm motility and TMSC. Total and progressive motility was found to be significantly associated with total cholesterol (p<0.05). Infertile men having higher total cholesterol were found to have better total and progressive motility compared to men with less total cholesterol.Conclusions: Our findings demonstrated that lipid profile has significant correlation with semen parameters, specifically sperm concentration, count and motility.

Monitoring of Air and Water Bacterial Load in the Operation Theatres and Intensive Care Units of Selected Hospitals in Dhaka city: A Cross-Sectional Study

Background: Hospital milieu monitoring is an essential component for controlling healthcare associated infections (HCAIs) as it serves as the reservoir for pathogenic microbes. Aim of this study was to identify the bacterial load in Intensive care units (ICU) and Operation theaters (OT) air and water sources of selected tertiary care hospitals. Material & Methods: The study was organized in Microbiology department, BIRDEM General Hospital. A sum total 28 air samples & 6 water samples were collected from three selected hospitals and those were processed according to the set of protocols. Results: From air sampling, highest load of bacteria was found 480 CFU/dm²/hr in Hospital C ICU, 38.40 ± 9.99 CFU/dm²/hr in pre-OT samples & 218.2±43.35 CFU/dm²/hr in intra OT samples of Hospital C. From water sampling, unacceptable level of coliforms was found in all three hospitals. Among the non-pathogens, 24% – 37% Micrococcus spp. (normal flora) and 2% -18% Bacillus spp. (contaminants) were found in the OTs. Whereas pathogens found were Acinetobacter spp. (20.7%) followed by Pseudomonas spp. (19.4%), Klebsiella spp. (12.1%) & S. aureus (9.2%) in the ICUs. Conclusion: It could be deduced from the study that environmental sources such as air and water contaminations with multidrug resistant pathogens are an ultimate risk factor for all related to the healthcare settings, specially the indoor patients.

Prevalence and Factors Associated With Depression among School Going Adolescents in Bengaluru: A Cross-Sectional Study

Introduction: The period of adolescence involves a lot of emotional changes as it is a period of transition to adulthood demanding independence.Adolescents with depression are more likely to have anxiety, disruptive behavior disorder and substance abuse when compared to those who are not depressed. Objective: To estimate the prevalence of depression among school going adolescents and to assess the factors associated with depression among them. Method: A cross-sectional study was conducted among school going adolescents aged 13-16 years in the urban field practice area of a Medical College. Depression was assessed using Beck's depression inventory (BDI). Total 896 adolescents were included in this study. Single stage cluster sampling method was done in which schools were considered as clusters and students constituted the sampling units. Schools were selected by simple random sampling technique using lottery method. Results: In this study about 45.2% of the adolescents had depressive disorder, out of which mild depression was reported among 22.2% students, 12.4% moderately depressed and 10.6% severe depression. Factors like mother's education, lack of communication by father and mother with their children, lack of needs satisfied by the fathers of the adolescents (61.9%), father's role in adolescents' life (62%) and domestic violence in family (69.7%) were some of the important reasons for developing depression among adolescents. Adolescent whose parents were having conflict (69.2%) were found be depressed when compared to those adolescents whose parents had no conflicts this difference was statistically significant (p<0.05). Conclusion: The prevalence of depression was found to be 45.2%. Finding of the study emphasizes the need for creating awareness about the early identification of behavioral changes leading to depression among adolescents by the parents and teachers. It is also important to emphasize to the parents on how their relationship and behavior towards the family affects the mental wellbeing of the adolescents.

Case report of a child with Myelin Oligodendrocyte Glycoprotein Associated Disease (MOG-AD)

@#Myelin oligodendrocyte glycoprotein associated disease (MOG-AD) is an inflammatory disorder of the central nervous system characterized by immune-mediated demyelination. We present a case of a patient with subacute to chronic progressive bilateral motor weakness associated with encephalopathy, which led to the diagnosis of MOG-AD. This case highlights the importance of recognizing the diverse clinical manifestations and the need for a multidisciplinary approach in the diagnosis and management of MOG-AD. In this review, we discuss the pathophysiology, diagnostic criteria, imaging findings, treatment strategies, and prognosis of MOG-AD based on the available literature.

Case report of Neuroschistosomiasis in a Child

@#Neuroschistosomiasis is a serious complication of schistosomiasis, where Schistosoma parasites migrate to the central nervous system. It is often overlooked but can cause significant neurological symptoms. We present a 10-year-old male with headache and papilledema, emphasizing the importance of considering neuroschistosomiasis in patients with neurological symptoms and a history of schistosomiasis exposure. Early diagnosis and timely treatment with antischistosomal drugs and corticosteroids are crucial for positive outcomes. Raising awareness and implementing appropriate management approaches can improve the prognosis of neuroschistosomiasis.

Role of Magnetic Resonance Imaging in Evaluation of Perianal Fistula

Introduction: Perianal fistula is an abnormal infected tract that connects the internal opening in the anal canal to the external opening in the perianal skin. It is an important cause of significant patient morbidity related to the lower intestinal tract. Magnetic resonance imaging (MRI) is the imaging modality of choice in the pre-operative assessment of perianal fistulas due to its excellent soft tissue resolution to accurately demonstrate the anatomy of the perianal region and the relationship of the fistulous tracts to the pelvic diaphragm and the ischiorectal fossae. Aims and Objectives: This study aims to assess the role of MRI in evaluation of perianal fistula and to correlate the imaging findings with post-surgical data. Materials and Methods: In this prospective study, 50 patients of all age groups with perianal fistulas were evaluated by MRI in the Department of Radiodiagnosis, Gandhi Medical College and Hamidia Hospital over a period of 1 year. MRI was performed on 1.5 Tesla Hitachi ECHELON SMART - 523 MRI machine using the required protocol and sequences. Fistulas were classified according to St James’s University Hospital MRI classification system and imaging findings were compared with post-surgical data. Results: MRI could detect the presence of fistula in all 50 patients, indicating 100% sensitivity. Most patients (68%) had internal opening on the posterior aspect of anal canal. Active fistulous tract was seen in 43 patients (86%) and chronic fibrosed tracts in 7 patients (14%). The most common type according to MRI grading was Grade I (54%), followed by Grade II (30%), Grade III (8%), and Grade IV (6%), respectively. MRI correctly described the type of fistula in 96% of cases. Conclusion: This study concludes that MRI proved as a valuable imaging modality in evaluation of perianal fistula and should always be performed in patients before surgery.

Vaccines in the United States: a systematic review on history of evolution, regulations, licensing, and future challenges

Vaccines are credited with reducing or effectively eradicating a number of infectious diseases such as smallpox, measles, and diphtheria. Particularly in nations like the United States, where a large number of infectious diseases were prevalent, vaccines proved to be timely interventions. The approval procedure for vaccines in the United States is regulated by the Center for Biologics Evaluation and Research. Vaccine development is often found to be demanding and requires astute knowledge and understanding of recent developments by physicians and researchers to ensure that effective vaccines are made available to the masses with minimum risk. This article aims to illustrate the regulatory scenario with regards to vaccine development and licensure in the United States with a brief look at the origin of vaccines and their regulations in the nation. Also, it details the challenges faced by the United States vaccine industry to remain relevant in today’s constantly evolving world.

Vaccines in the United States: a systematic review on history of evolution, regulations, licensing, and future challenges

Vaccines are credited with reducing or effectively eradicating a number of infectious diseases such as smallpox, measles, and diphtheria. Particularly in nations like the United States, where a large number of infectious diseases were prevalent, vaccines proved to be timely interventions. The approval procedure for vaccines in the United States is regulated by the Center for Biologics Evaluation and Research. Vaccine development is often found to be demanding and requires astute knowledge and understanding of recent developments by physicians and researchers to ensure that effective vaccines are made available to the masses with minimum risk. This article aims to illustrate the regulatory scenario with regards to vaccine development and licensure in the United States with a brief look at the origin of vaccines and their regulations in the nation. Also, it details the challenges faced by the United States vaccine industry to remain relevant in today’s constantly evolving world.

Renal Doppler Indices in Chronic Liver Disease and its Role in Predicting Hepatorenal Syndrome

Introduction: Hepatorenal syndrome (HRS) is the most serious complication of renal dysfunction in patients with chronic liverdisease (CLD). Renal arterial vasoconstriction may persist for weeks, even months before an increase of blood urea nitrogenor serum creatinine values can be discovered.[1] Duplex Doppler ultrasonography of the kidneys is an easy and non-invasivemethod to assess blood flow and arterial vascular resistance as a parameter for vasoconstriction.[2-4] Intrarenal resistive index(RI) may be superior to serum creatinine levels as an indicator in patients with liver cirrhosis for the detection of patients at riskfor the development of HRS.Objective: The objective of the study was to correlate renal Doppler indices with serum creatinine levels in various stages ofCLD and to determine its role in predicting the risk for developing HRS in patients of CLD.Materials and Methods: Grayscale, color flow, and duplex Doppler ultrasonography were performed inpatients of CLD, whichwere divided into four groups with increasing clinical severities. There serum creatinine level was compared with renal Dopplerindices in various groups of increasing severity.Results: Most common cause of CLD in our study population was alcoholism (62%). About 65% of cases show irregular liversurface, and irregular liver surface is significantly higher in Groups II, III, and IV versus Group 1. Heterogeneous, homogenous,and fatty echo texture were showed by 78%, 11%, and 11%, respectively. Mean peak systolic velocity and end-diastolic velocityin our study are 33.99 cm/s and 11.55 cm/s, respectively. Mean pulsatility index in cases was 1.17. In our present study, RIlevel was significantly higher in cirrhotic patients, and there is a significant association between RI and study groups. As theseverity of liver disease of group increases, the RI value also gets elevated.Conclusion: Intrarenal RI seems to be a helpful predictor to identify a subgroup of CLD patients with a higher risk of developingkidney failure or HRS, which can translate into the early initiation of treatment for impending HRS.

Magnetic Resonance Imaging in Evaluation of Avascular Necrosis of Femoral Head

Introduction: Avascular necrosis (AVN) of the femoral head is one of the common causes of pain and disability of hip. Impairedblood supply and increased intraosseous pressure are predominantly responsible for the necrotic process, which eventuallyresults in collapse of the femoral head. Magnetic resonance imaging (MRI) is the preferred investigation for the evaluation of AVN.Aims and Objectives: This study aims to assess the role of MRI in the evaluation of clinically suspected cases of AVN of hipand to describe the imaging features along with proper staging.Materials and Methods: In this prospective study, 100 patients of all age groups with clinically suspected cases of AVN offemoral head were evaluated by MRI hip in the Department of Radiodiagnosis, Gandhi Medical College and Hamidia Hospitalover a period of 1 year. Detailed history and associated risk factors were asked from all patients. MRI hip was then performedon 1.5 Tesla Hitachi ECHELON SMART - 523 MRI machine using the required protocol and sequences. The imaging findingswere studied and proper staging was given.Results: In our study of 100 cases of AVN, 132 femoral heads were involved (unilateral 68 and bilateral 32 cases). The most commonrisk factor associated was alcohol consumption. The most common quadrant of femoral head affected was anterosuperior (49.3%). Themost common stage of AVN was found to be Grade III – 39.4% (Ficat and Arlet classification), Type C – 47% (Mitchell’s classification),and Stage IIIC – 37.8% (Steinberg classification). MRI could detect early AVN in 50 femoral heads, in which radiographs were normal.Conclusion: This study concludes that MRI is the modality of choice for diagnosing and staging AVN. Early diagnosis andappropriate treatment is associated with better outcome.

​Perinatal Outcome of the Second Twin with Respect to Mode of Delivery – A Prospective Analysis

Aims and Objectives: The aim of the study was to study the perinatal outcome of the second twin with respect to mode of delivery.Materials and Methods: Consecutive pregnant women having twin pregnancies beyond 28 weeks of gestation admitted tothe department of the institute during the period from April 2016–May 2017 were included in the study.Results: A total of 50 cases were enrolled in the study. Vaginal, ventouse/forceps, and lower segment cesarean section (LSCS) werethe different modes of delivery consisting of 48%, 2%, and 50% of cases, respectively. Perinatal loss of the second twins was higher inLSCS group consisting of 61.11% of cases. Perinatal loss of the second twins was 100% for monochorionic monoamniotic pregnancieswhereas 33.33% for monochorionic diamniotic and 29.03% for dichorionic diamniotic pregnancies. The delivery time interval of <10 minbetween the first and second twin had the higher second twin perinatal loss, i.e., 37.14% and less poor APGAR score, i.e., 57.14% incomparison to time interval of 10–30 and >30 min groups but statistically insignificant. For second twin, vertex presentation had higherpoor APGAR score compared to non-vertex presentation, i.e., 65.63% versus 55.56%. Poor APGAR score was found to be higher incesarean section, outlet forceps and vaginal mode of deliveries consisting of 60%, 100%, and 62.5%, respectively. In overall, 64% ofsecond twins and 84% of first twins were alive, and the difference had P = 0.034. About 62% of second twins and 34% of first twinswere having poor APGAR score of <7, and the difference had P = 0.005. About 67.44% and 76.92% of second twins were found tobe alive higher in maternal age group of ≥20 years and multigravida group, respectively, having P < 0.05. About 64.52% and 100% ofsecond twins were alive higher in <37 weeks gestational age group and birth weight of second twin ≥2500 kg groups, respectively, withP < 0.05. Second twins were having higher alive in vertex-non-vertex presentation, vaginal mode of delivery for both the twins, DCDAgroup and intertwin delivery interval of 10–30 min groups consisting of 71.43%, 72%, 70.97%, and 77.78%, respectively, with P > 0.05.Conclusion: The perinatal mortality of 2nd twin is higher than that of 1st twin in terms of monochorionic, prematurity, and lowbirth weight. Intensive labor monitoring, safe delivery, and improved neonatal care facilities appear to be the major areas toimprove the perinatal outcome.

Juvenile-onset Huntington’s Disease: A Rare Case Report

Juvenile-onset Huntington’s disease (JHD) is a rare autosomal dominant neurodegenerative disorder of the central nervoussystem characterized by the presence of abnormal involuntary movements, rigidity, and ataxic gait. We are presenting a rarecase of a 9-year-old male who was referred to the Radiology Department of Gandhi Medical College and Hamidia Hospital formagnetic resonance imaging (MRI) brain with complaints of progressive impairment of gait, bradykinesia, and marked posturalinstability for the past 2 years. The patient also had a history of episodes of seizures for 4 years. MRI findings revealed: Atrophyof bilateral caudate nuclei and putamina of basal ganglia.

Magnetic Resonance Imaging in Evaluation of Hip Pain

Introduction: Hip pain is a common problem and a major disabling condition that affects patients of all ages. Magnetic resonanceimaging (MRI) plays an important role as it provides valuable information regarding various hip pathologies. Thus, it is the modalityof choice for evaluation of hip pain as it has a profound impact on the subsequent treatment and is useful tool for the clinicians.Aims and Objectives: This study aims to assess the role of MRI in evaluation of painful hip joints and to describe the imagingfeatures along with differential diagnosis of the various hip pathologies.Materials and Methods: In this prospective study, 50 patients of all age groups with hip pain were evaluated by MRI hip in theDepartment of Radiodiagnosis, Gandhi Medical College and Hamidia Hospital, over a period of 1 year. MRI hip was performedon 1.5 Tesla Hitachi ECHELON SMART - 523 MRI machine using the required protocol and sequences. The possible diagnosiswas given and non-specific imaging findings were further confirmed by cytology/histopathology wherever indicated.Results: In our study of 50 cases, MRI could detect the exact cause of hip pain in 49 patients. The most common cause wasavascular necrosis of femoral head (50%) followed by infective arthritis (12%). Other causes were transient synovitis, sacroiliitis,osteoarthritis, slipped capital femoral epiphysis, Perthes disease, and various neoplastic conditions of the hip.Conclusion: This study concludes that MRI proved as a valuable imaging modality to accurately diagnose various pathologiesaffecting hip.

Congenital Right Lung Agenesis With Dysplastic Sternum - A Constellation Of Two Rare Cases

Congenital lung agenesis is a rare disease spectrum which includes complete agenesis, lung aplasia (with rudimentary bronchus)and partial agenesis. It is embryological anomaly arising from failure of unilateral lung bud to develop. Sternal dysplasias are veryrare entities with only few reported cases[1] . We present case report of a 1 year old female with complete right lung agenesisassociated with dysplastic sternum and vertebral segmentation anomaly

Evaluation of placental thickness as a sonological indicator for estimation of gestational age of foetus in normal singleton pregnancy.

Background: Gestational age is frequently over or under estimated, as the conventional gestational estimation is based on the last menstrual period and on ultrasonography. Many people are unaware of their last menstrual period and irregular menstruation and ultrasonography is bound to have a bias, thereby posing difficulties in the estimation gestational age. Placental thickness measured at the level of umbilical cord insertion appears to be a new promising parameter for estimation of gestational age of fetus as placenta is a maternal foetal organ and its size is a reflection of the health and size of the foetus. It provides the physiological link between a pregnant woman and the fetus.Measurement of placental thickness is relatively simple and very useful. In our present study we have tried to measure Placental thickness at the level of umbilical cord and determine its relationship with gestational age of foetus in normal singleton pregnancy. Methods: The current crossectional study was conducted at the department of radiodiagnosis, Gandhi medical college and Hamidia hospital, Bhopal from April 2012 to December 2014. This is a hospital based study with a sample size of 199 normal antenatal women. All the subjects were enrolled with detailed oral and written consents. All examinations were performed using GE logic 3 expert scanner with 3.5 MHz convex array transducer. Placental thickness in millimeters was measured at the level of insertion of the umbilical cord. Data was compiled in MS excel sheet and analyzed using online statistical calculator, chi square test and pearson correlation coefficient were applied with value of P <0.05 was considered statistically significant. Results: In the total study group of 199 normal antenatal women, the age ranged between 18yrs to 34 years and the mean age was between 20 and 25 years of age. Anterior placenta was noted to be the most common location amongst the study sample. It is observed that placental thickness correlates with gestational age and gradually increases as gestational age increases. To prove that there was a correlation the between placental thickness and the gestational age, the Pearson correlation coefficient was found to be r = 0.98 and the p value was <0.001, thereby establishing a positive correlation between the two variables, indicating placental thickness measured in millimeters increases with gestational age measured in weeks and were statistically significant. Conclusion: A linear increase in mean placental thickness with gestational age was observed using correlation analysis in our present study conducted to determine the relationship between placental thickness and gestational age. Placental thickness measured in millimeters increases with gestational age from 11 weeks to 37 weeks. Placental thickness can be used as a predictor of the gestational age, in women in whom the last menstrual period is unreliable or is not known. In instances when femoral length was difficult to measure due to excessive foetal movements, Placental thickness was found to be a reliable alternative biometric measurement in calculating gestational age.

Insulin Secretory Status in Obese Female.

Background: In obesity insulin hypersecretion is a key feature indicating the abnormal pancreatic beta cell function which is the fundamental defect in the development of NIDDM, hypertension and cardiovascular diseases. Objective: To assess the secretory status of insulin in adult obese female. Methods: The present study was a cross sectional analytical study and conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2012 to June 2013. 50 obese female subjects of 20-40 years were included from Out-patient Department (Obesity clinic) of BIRDEM Hospital, Dhaka and by personal contact from different areas of Dhaka city. 50 age matched, healthy non-obese female subjects selected as controls . Fasting serum insulin level was measured by ELISA and fasting glucose level was measured by Glucose oxidase method. The insulin secretory status was calculated by HOMA-%B using HOMA software. For statistical analysis unpaired Student’s ‘t’ test and Pearson’s correlation coefficient (r) test were performed as applicable . Result: Mean fasting serum insulin and HOMA%B (P<0.001) were higher in the obese than that non obese. Fasting serum insulin level and HOMA%B showed significantly positive correlation with WHR. Conclusion: This study concludes that obese individual develops a state of insulin hypersecretion and hyperinsulinemia.

In vitro comparative evaluation of the physical and mechanical properties of two soft-liners coated with different types of coatings

Aim: To evaluate the changes on the physical and mechanical properties of acrylic and silicone based soft liners after applying four different types of coatings

Methods: A total of 60 samples were prepared and divided into two major groups viz. Group A-Exact-On [30 samples] and Molloplast-B [30 samples]. Group A and B were further subdivided into 5 subgroups I, II, III, IV and V containing 6 specimens each. The samples were coated with four different types of coatings and were compared to the uncoated control group [subgroupl]. Main composition of two types of Monopoly were chemically activated methylmethacrylate monomer, clear methylmethacrylate polymer, heat activated methylmethacrylate monomer. Two new types of coatings were made with n-butyl cyanoacrylate. These two coatings were never tried before in any literature review. The coated samples were tested for Hardness, Permanent deformation, Tensile strength, Water absorption determination and the coated surfaces were observed under SEM and compared with the uncoated control group

Results: Molloplast-B, a silicone based had longer shelf life but a coated acrylic based liner was seen to be equally good. Cyanoacrylate monomer coating and self cure monopoly coating were superior to other coatings. All results were statistically analyzed by 2-way ANOVA. The mean values for hardness ranged from 24.16 to 29.33 Shore A for Group A and 41.50 to 42 Shore A for Group B. Values of permanent deformation ranged from 1.01 to 0.93% for the Exact-On [Group A] and 0.158 to 0.140% in coated Molloplast-B samples [Group B]. Mean values of Tensile strength ranged from 5kg/cm[2] to 6.00kg/cm[2] in Group A and 16.33 kg/cm[2] to 17.67kg/cm[2] in Group B. It was observed that among the coatings Cyanoacrylate Monopoly coating was more efficient in preventing water absorption and leaching followed by Cyanoacrylate Monomer coating

Conclusion: None of the coatings affected the physical properties of tissue conditioners. All coatings prevented water absorption from tissue conditioner and prolonged the life of tissue conditioner

A cross-sectional triangulation analysis of the knowledge, attitudes and practices of patients from the endocrinology clinic of the Philippine General Hospital on the use of herbal dietary supplements

OBJECTIVE: This study aimed to determine the knowledge, attitudes and practices (KAP) of a selected population of patients on herbal dietary supplements (HDS).METHOD: Methodological triangulation was used to generate a conceptual framework on HDS KAP. A survey of 175 patients was performed to measure knowledge and attitudes regarding HDS and SPSS was used for data analysis. Inverviews and focus group discussions (FGDs) were conducted to further explore the attitudes and practices, and constant comparison method was used for analysis of responses.RESULTS: Respondents were generally aware of HDS. Majority of survey respondents believed that HDS are different from conventional drugs (52.0%, pThe attitude toward HDS was generally positive. Majority (64.0%, pAmong the survey respondents, only 22% were HDS users. Family was shown to promote use while cost deterred their use.CONCLUSION: Individual knowledge and attitudes on HDS exert significant influence toward HDS practices. Factors that promote use are poor knowledge and positive attitudes toward HDS. Good knowledge seems to lead to judicious use or non-use.