Comparative study of prevalence of burn out among medical students from two medical colleges in Eastern India

Background: Emotional exhaustion, and reduced perception of personal accomplishment is commonly defined as burn out syndrome. This may develop when there is significant stress without adequate support and resources in the face of work overload, as commonly happens with physicians and undergraduate medical students.Methods: This work attempted to study the level of burn out among all the second professional medical students in two different medical colleges and compare the trends of an urban medical college with a college in the outskirts of the city. 278 students from two medical colleges participated in the study wherein they were given standard questionnaires for assessment of stress, support, satisfaction and control parameters.Results: Overall 169 students of the 278 (60.79%) interviewed had scores correlating with burn out. Both college students showed burnout in the various parameters individually like stress, lack of support, dissatisfaction, lack of control and perception of success. There was a significantly greater prevalence of burn out scores among students in the city college (123 students or 60.84%) compared to those studying in the rural medical college (46 students or 41.07%) (p ?0.05)Conclusions: Burn out syndrome was more prevalent among city students compared to rural students. Individual as well as organizational interventions need to be targeted to prevent burnout among medical students.

Assessment of perception of undergraduate medical students & teachers about pharmacy practical classes in pharmacology.

Background: Pharmacology and pharmacy practice has undergone a sea change over the last century. The most notable change in pharmacy in modern times has been the virtual disappearance of the preparation and compounding of medicines. Pharmacy practical classes still form a part of the MCI curriculum in Pharmacology undergraduate teaching in many states of India including West Bengal. This study was undertaken to assess the attitude of students as well as teachers towards continuation of these practical classes in the curriculum and possible alternatives. Methods:102 students and 12 teachers participated in the study answering a structured and pre-tested questionnaire anonymously. Results: The results showed that nearly 84% students and 50% teachers wanted these practical classes to continue citing various reasons. The most popular alternative to these classes remain demonstration of clinical effects of drugs which was supported by 88.23% students and 91.66% teachers. Conclusion: Pharmacy practical classes can be continued in pharmacology curriculum. But the better beneficial alternatives can also be considered which may be more beneficial to the students.

Burn Out Among Medical Students - A Study Across Three Medical Colleges in Eastern India.

Burnout is described as a syndrome of emotional exhaustion, and reduced personal accomplishment that may develop when there is significant stress without adequate support and resources in the face of work overload, as commonly happens with physicians and undergraduate medical students. Materials and Methods : This work attempted to study the level of burn out among all the third and fifth semester medical students in three different medical colleges. 596 students from three medical colleges participated in the study wherein they were given standard questionnaires for assessment of stress, support, satisfaction and control parameters. Results : Overall 310 students of the 596 (52.01%) interviewed had scores correlating with burn out. All the colleges across semesters showed burnout in the various parameters individually like stress, lack of support, dissatisfaction, lack of control and perception of success. Conclusions : Individual as well as organizational interventions need to be targeted to prevent burnout among medical students.

LDL Susceptibility to Oxidative Stress in Smokers.

In 30 cigarette smokers and in 30 sex and age matched nonsmoker controls, susceptibility of LDL to oxidative stress following incubation with copper sulphate (1mM) was measured in terms of thiobarbituric acid reactive substance. Susceptibility of LDL to oxidation in smokers was found to be 0.514131±0.468231picomol MDA/μg protein/hr. LDL susceptibility to oxidation in non-smokers was found to be 0.711726 ± 0.447324picomol MDA/μg protein/hr. These two values were not statistically different (p=0.1) by unpaired T test. This study therefore suggests that cigarette smoke does not increase LDL susceptibility to oxidation.

Montelukast Induced Hypertriglyceridemia.

Montelukast a LT4 receptor antagonist is a prophylactic agent used in chronic asthma, to improve asthma control and reduce the frequency of asthma exacerbation. Advantage of Montelukast is, it is well tolerated in both adult and children upto 6 years of age. Suspected adverse effect reported to U.K, CSM follow the launch of Montelukast are anaphylaxis, angioedema, urticaria, chest pain, vertigo, athralgia, fever. Further suspected side effects are nightmare, palpitation, and sweating and Churg Strauss syndrome. Hypertriglyceridemia associated with this agent is rarely found in any published medical report or literature. This is a case of a male patient who was suffering from chronic asthma since childhood, developed allergic rhinitis since November´10. He developed hypertriglyceridemia and associated lipid profile abnormality after taking Montelukast and was also receiving salbutamol inhalation since childhood. His lipid profile before Montelukast administration was normal. Routine investigation done 4 months following drug intake shows serum triglyceride to be 732mg/dl.Montelukast was immediately withdrawn, but salbutamol was continued The triglyceride level reaches near the base line 4 months following drug withdrawal. This case highlights a rare case of Montelukast induced hypertriglyceridemia. Physician should be vigilant of the fact that Montelukast can induce hypertriglyceridemia following therapy with it.

Drug utilization in a rural community- a longitudinal study.

Background & objectives: Around 50% of all medicines are prescribed, dispensed or sold inappropriately while 50% of patients fail to take their medicines appropriately. The optimum efficacy of a drug requires the firm compliance from the patient and honest co-operation from both the patient and their families. With this background this study was conducted to find out the pattern of drug utilization in a rural community of Maharastra, to detect the magnitude of drug failure and to find out its associates. Methods: A Community based longitudinal study was conducted in a village (Jaulgaon), in Maharastra (Central India), belonging to the field practice area of Mahatma Gandhi Institute of Medical Sciences Sewagram among 256 persons of all age groups. Monthly house to house visits were conducted in the selected households using a predesigned pretested schedule following WHO guidelines for 12 months. Variables studied are disease type, disease episode, doctor consulted (Allopathic system), drugs used, mode of preservation of prescription and drugs, compliance to doctor’s advice, adverse drug reactions and outcome. Results: 203(79.3%) persons suffered from some illness. Total illness episodes were 446 (1.74 per person per year). A doctor was consulted for 330 episodes (74%). Anti-microbials top the list of prescribed drugs. About 15% of the episodes had adverse reactions. Non-compliance to drug use was 18.5%. Adverse outcome (Drug failure & Death) was seen in 28.5%. Drug failure was very significantly associated with Non-compliance and adverse reaction. Interpretation & conclusion. There were drug failures among 27.87% of the study population amounting to 35.39% of the total expenditure for health-care. Present study highlights the importance of community awareness for compliance to drug use.

A longitudinal study on health expenditure in a rural community attached to mahatma Gandhi Institute of Medical Sciences, Sewagram, Maharashtra.

Community based study on health expenditure is a rarity in India. A Rural Community based longitudinal study was undertaken in Jaulgaon village of Maharashtra, with objectives of finding out the health expenditure contributed by direct treatment, related travel and relevant loss of wages with certain pertinent associated factors. 50% of the village population was studied (N = 256) by pre-designed, pre-tested schedule following WHO guidelines. A monthly house to house interview was conducted over 12 months. During study period, 78% study subjects suffered some illness with mean illness episode 1.74/person and 6.37/family without any sex difference. The annual health expenditure of the community was Rs 1,576/family, 4,31/person and 2,42/episode, which was about 4.3% of their income. The major part of the expenditure (82%) was for direct treatment cost, followed by loss of wages (12%) and travel related cost (6%). Expenditure was seen to be significantly associated with family income (P = 0.000) and education (P = 0.006).