A cross-sectional survey to assess the drug disposal practices of unused and expired medicines among lay public visiting a tertiary care hospital in an urban metropolis

Objectives: A cross-sectional survey was conducted to evaluate the knowledge, awareness and practice among the lay public regarding storage and disposal of unused and expired medicines. Materials and Methods: This was an observational, cross-sectional, single-centre and questionnaire-based survey. After obtaining Institutional Ethics Committee approval, the study was conducted using a pre-validated structured questionnaire distributed among the lay public visiting a tertiary care hospital located in an urban metropolitan city. Results: Four hundred of 720 individuals visiting the tertiary care hospital participated in the survey. The results revealed that 75% had never referred to any sources to get the correct information about the proper and safe disposal of medicines and had no knowledge regarding the same. About 12.75% of study participants reported that they were educated regarding the disposal of medicines by their treating physicians (RR: 0.71 [95% CI: 0.51–0.99]) when compared with the other sources of information (18%) with statistically significant contribution made by the physicians (p<0.05). About 67% of the public stored their medicines at room temperature. Majority (83.75%) of the study participants reported that they disposed unused and expired drugs in the dustbin. Only 42.5% of the public knew the detrimental effect of improper drug disposal on human health and our ecosystem. In addition, 80% (320/400) of the participants confirmed that, given the option, they would prefer to return the unused or expired drugs to the pharmacy shops from where the medicines were purchased. Conclusion: There is a need to educate drug consumers/general public about safe and proper disposal of unused/ expired medicines. Health-care professionals, governments and policymakers should offer training to educate the general public about Indian regulations for safe disposal of unused/expired medicines.

Prevalence and Risk Factors for Severe Acute Malnutrition among Less Than Five Children from an Urban Locality of Surat City, Western India

Introduction Undernutrition puts children at greater risk of dying from common infections, increases the frequency and severity of such infections, and delays recovery. The percentage of undernutrition, stunting and wasting in children under 5 years of the age in India are 35.7, 38.4 and 21.0 respectively. The etiology of malnutrition is complex and multi-factorial usually a consequence of inadequate dietary intake and various diseases. Methodology: A community based case-control study was conducted among children aged 6 to 59 months, registered at the Anganwadi centers in an urban locality of Surat city, Gujrat. Study population was divided into cases and controls using WHO classification based on anthropometric measurements. Result: The prevalence of undernutrition and severe acute malnutrition among the under-five children were 26.2 and 8.7% respectively. Significant association was found between nutritional status of the children and type of the family( OR 3.84, 95% CI =1.87-7.86, p = 0.000), low birth weight (OR 4.85, 95% CI =2.29 � 10.26, p = 0.000), poor appetite (OR = 2.89, 95% CI = 1.38-6.01, p = 0.004), bottle feeding (OR = 5.41, 95% CI = 1.91-15.29, p= 0.001) and children with habits of eating wafers/candies (OR = 21.99, 95% CI = 9.02-53.60, p = 0.000). Conclusion: Severe acute malnutrition continues to be an important health concern among under five children in the urban area and is affected by many risk factors which can be mitigated through structured and timely interventions using IEC materials.

Exploration of the Angiogenic Potential of Honey.

Aims: The present study was conducted to confirm the angiogenic potential of honey using Chick Chorioallantoic Membrane (CAM), an in ovo model and to study its effect on Vascular Endothelial Growth Factor (VEGF) expression in the CAM tissue. Attempts were also made to identify the probable active constituents present in honey that contributed to its angiogenic potential. Methodology: Honey was evaluated over concentrations ranging from 0.015 to 25% v/v and the extent of angiogenesis was quantified using stereomicroscopy. VEGF expression at transcript level was determined by RT-PCR. Erythropoietin and Heparin were used as positive and negative controls respectively. Four known constituents of honey viz., Glucose, Proline, Vitamin C and Hydrogen peroxide were tested by biochemical methods. Results: New blood formation was seen at all the concentrations tested, however the proangiogenic effect was greater at lower concentrations. These results were significantly greater than that seen with erythropoietin, the positive control. VEGF mRNA expression in CAM tissue also demonstrated similar findings. Among the constituents tested, Vitamin C and Hydrogen peroxide were observed to be associated with the angiogenic effect of honey. Conclusion: The study thus confirms the pro-angiogenic potential of honey at low concentrations. This effect is probably due to the presence of Hydrogen peroxide and Vitamin C and is mediated via alteration in VEGF expression.