This was a cross sectional questionnaire-based study, conducted at Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry. Before initiation of the study, Institutional Ethics Committee approval obtained and the study was conducted for a period of 3 months. Duration of the study November 2018 - January 2019.The undergraduatestudents studying in second MBBS, of all ages and both the gender were included in the study. Written informed consent was obtained from all the study participants. A semi –closed, pre validated questionnaire model was used in this study (Questionnaire enclosed in Annexure 1). A brief description about the purpose of the study and the procedure to complete the questionnaire was explained in detail to all the students. The candidates were instructed and properly guided to complete their response within the stipulated time. The results were analyzed and expressed by descriptive statistics, such as counts and percentages.
counter (O.T.C) drugs Yes No
No of students 16 154
Most of the students are practicing self-medication which indicates high incidence among medicos. There is a difference in gender among that practicing self- medication. Females were more may be due to their menstrual and hormonal problems. Mostly they are using medicines for simple ailments like cold, fever etc. which are non-serious. The high use of analgesics for self- medication confirms the findings that analgesics are the commonly used over-the-counter medicines. 13 These results were consistent with the study “Popularity of self- medicationamongmedicalstudents AIIMS” by Gupta YK. 14 Multivitamins were also used commonly as supplements for promoting health, for preventing the illness, for boosting the immune system, for prevention of stress and to top up the regular nutrition. 15 Self-medication with antibiotics is of public health concern because inappropriate use of antibiotics results in antibiotic resistance and in emergence of mutant forms of microbes which is a major problem worldwide especially in developing countries like India. 16
Analysis of source of knowledge regarding selfmedication revealed that old prescriptions, text books and teachers contributed in majority and this was in one way or the other related to their study course. Internet was a major source for information even with medicalstudents. These findings are in concurrence with earlier reports which have also shown previous old prescriptions, text books as major source of information. 12,14,21 The findings of current study do underline the shift in trends from the traditional teacher to inclination towards internet. Such a scenario calls for frequent evaluation from time to time to have insight in changing pattern of society.
ABSTRACT: Over the counter (OTC) drugs are drugs easily available without the prescription of a registered medical practitioner (RMP) and self-mediation practices of these drugs are very common in medicalstudents especially in diarrhea which mostly requires dehydration therapy only. But very few reports are available regarding the use of OTC antidiarrhoeal drugs. The aim of the study was designed to assess the practice of self-medication for diarrhea among second year medicalstudents in RIMS, Ranchi, Jharkhand. This was a cross sectional study conducted amongmedicalstudents in March-April 2017. Data was collected through self- administered questionnaire and result was expressed as percentage frequency.
Attitude and practices regarding pharmacovigilance In our study, 26% of participants consider that lack of time is the primary reason for not reporting ADRs, 22% of entrants have difficulty in diagnosing ADRs, 17% of participants do not know where and whom to report ADRs, 4% entrants are concerned about the legal aspects of reporting ADRs and 26% candidates believe that a combination of these above factors discourage them from reporting ADRs. Various other factors that discourage participants from ADR reporting include the belief that the ADR in question was already well known and common, the ADR is not serious and uncertainty concerning the causal relationship between the ADR and drug. Strategies to improve reporting of ADRs by including topics of PV in medical curriculum and educating them that any suspected ADRs are to be reported even if one is not sure about it. Other modalities to encourage HCPs to report ADRs include easy access to ADR forms, toll free numbers to contact AMC of the institution and CME activities to create the awareness about the building of Indian database of ADR and PV. These activities may reduce the barriers and misconceptions that discourage reporting of ADRs. All the three groups (sixth, eighth- semester students and doctors) felt that ADR reporting is necessary, and that PV should be taught in detail to HCPs.
Self-medication is a common practiceamong a group of health workers in Nigeria, according to Ehigiator O et al. 10 Undergraduatemedical and paramedical students have easy access to information about pharmaceuticals from drug indices, literature and social media. 11 A previous study from All India Institute of Medical Sciences, New Delhi reported that self-medication was significantly higher amongundergraduatemedical and paramedical students in India and it increased due to their medical acquaintance. 12 Hence, the present study was conducted to evaluate the prevalence of self-medication and perception towards self-medicationamong the undergraduatemedical and dental students of the Pacific Medical College, Udaipur, Rajasthan, India.
in a tertiarycare center
Vineeta Sawhney, Mohammad Younis Bhat*, Zorawar Singh
Self-medication can be defined as the use of non-prescription medicines by people on their own initiative. 1 This includes acquiring medicines without a prescription, resubmitting old prescriptions to purchase medicines, sharing medicines with relatives or members of one’s social circle or using leftover medicines stored at home. 2 Self-medication is a common practice worldwide, 3-7 which increases the chances of illicit use of drugs 8 and drug dependency and most of all masking the sign and symptoms of underlying disease, hence are complicating the problem, creating drug resistance, and delaying diagnosis. 9-13 It is also alarming that the prevalence rates are on the rise despite efforts to limit this problem 14 leading to wastage of resources, serious health hazards such as adverse drug reaction and prolonged morbidity. 15
Background: Health care sector is clearly a high-risk sector for acquiring occupational hazards and have given rise to a debate on the need for a specific approach in order to improve the protection of the health and safety of hospital personnel. Many health care professionals in hospitals are exposed to significant occupational health hazards and consequently are at high risk of work-related diseases. This study aims to assess the knowledge, attitude, practice of medicalstudents on occupational hazards faced by health care professionals.
Shashi Marko*, Mahesh Chandra Alawa
Selfmedication is the use of drugs without a Doctor’s advice. Selfmedication is the treatment of common health problems with medicine that are taken on patient’s own initiative or on advice of a pharmacist, without professional supervision. It is now becoming a common practice in many countries mainly due to lack of access to health care, easy availability of OTC drugs in market and poor drug regulatory practices. 1 Globally the prevalence of selfmedicationpractice is inconsistent ranging from 32.5 to 81.5%. 2-4
In our study, only 45% participants think that ADR reporting is a professional obligation which is less as compared to other studies. 12,20,21 This is the attitude component which needs to be modified for improving the underreporting of ADR. Good knowledge and attitude remove the misconceptions, obstacles and potential barriers to the activities that we would like to implement thus initiating the practices for reporting. In the present study, 88% people feel that ADR reporting may improve patient safety. 81% students have also seen ADR but surprisingly only 20% people have reported ADR. We can clearly see that practices for reporting are lacking which is also an observation by various other studies. 21-23 Causes of underreporting are indifference to reporting, lack of interest in registration and lack of time for too many activities in the clinical routine. 24 This underreporting can be overcome by making easy access to registration forms, simplifying documents, toll free number assistance, financial incentives, creating more ADR centre, facilitating communication between registrars and pharmacovigilance centers would improve the notification rates of problems related to medication. 25-27 Studies evaluating the attitudes of nursing staff found that the lack of knowledge in completing the notification form, and the lack of time to report ADRs are the main causes of underreporting in this class. 28,29 Therefore, strategies must be developed to improve the acquaintance of these professionals to the pharmacovigilance service. There is a need for training and educational activities like CMEs for increasing the awareness about reporting of ADRs. Importance on adverse event reporting should be emphasized while teaching undergraduate and post graduate students.
participants agree that there is abuse of antimicrobials which is supported by similar results as obtained by Tarao MS et al. Practitioner should be regularly informed about antibiotics resistance pattern and avoid injudicious use. 12 Trust is associated with increased satisfaction and adherence to treatment, which is reflected as the restrictive attitude towards self-medication, McKinstry et al. Health care providers can educate the common public during consultations as 84.6% in our study agreed that they take time to explain in detail how antibiotics are to be used and discourage self-medication and injudicious use. 13
Thus, it is not a single grand challenge; it is rather a complex problem requiring concerted efforts of microbiologists, ecologists, health care specialists, educationalists, policy makers, legislative bodies, agricultural and pharmaceutical industry workers, and the public to deal with. In fact, this should be of everyone's concern, because, in the end, there is always a probability for any of us at some stage to get infected with a pathogen that is resistant to antibiotic treatment. 7-9 It is in this regards that this study was undertaken amongundergraduatemedical and dental students, in order to assess their knowledge and attitude concerning antibiotic usage, as well as their self-reported practices which are related to antibiotic usage. A better understanding of what the students know and believe about the issues of antimicrobial use and resistance can assist us in planning and preparing an effective and well-oriented educational intervention for them.
Thus our study demonstrates that selfmedicationpractice in students of Medical College is on the rise, the reason might be the awareness of drugs due to easy accessibility of information through books, internet pharmacy and through media too. If no strict action is taken, the incidence of adverse drugs reactions or drug interactions may go on increase with time. So essential measure should be taken to reduce the practice of selfmedicationamongstudents by conducting seminars, promoting the correct usage of drugs, or by delivering innovative lectures about the drugs. These activities will sensitize the students regarding irrational use of drugs and ultimately community will be benefitted.
Self-medication has its own benefits and drawbacks 1 . Self-
medication carries advantages only if used as a self-care component. Drawbacks include irrational drug use, increased drug resistance, adverse drug reactions, drug dependence etc. 1 Educational status, friends, family, society and drug advertisements etc., are influencing factors which affect the pattern of self-medication. 6 A study had described that educated people practiced self- medication more than illiterates. 7 Higher education and professional status has been mentioned as predictive factor. 8 It is equally practiced by doctors as well by medicalstudents. 9 Several studies had also mentioned that influences of pharmacology subject knowledge on increased prevalence amongmedicalstudents. 5,10 Not only medical knowledge of students but availability of drugs as free samples and influences of internet also plays a significant role. 11
Pharmacological treatment includes acute treatment taken at the time of attack to relieve pain and restore function and preventive treatment taken daily to reduce headache frequency. Improving the knowledge regarding the signs and symptoms of the disease, imparting relevant information about the diet and other lifestyle modifications help in prevention of migraine episodes and help thereby in achieving the desired therapeutic outcomes. Thus, it will also help in improving the quality of life of patients. 16-21 Increasing the awareness about the disease and its triggering factors will also help in managing this disorder effectively as many myths and misunderstandings related to the disease will decrease and the patients’ adherence to medication will also increase. Thus, this study was planned to assess the level of knowledge about migraine, its triggering factors and the various signs and symptoms associated with the disease.
However because of improper regulation and easy availability of prescription as well as non-prescription drugs, immoral self-medication has become a rampant practice in India. 5 Such inappropriate self-medication can result in wrong diagnosis which may lead to delayed treatment and failure of therapy, adverse drug reactions, dangerous drug interactions, incorrect manner and dose of administration, prolonged suffering, and risk of development of bacterial resistance and drug dependence. 6 Effective treatment of any ailment requires sound knowledge of disease as well as the drugs. Even though MBBS students have wealth of information at their helm to diagnose themselves and self-medicate, they lack in expertise. As future health care providers and prescribers, understanding practice of self-medication in these students is of paramount importance so that habits of ethical practice are inculcated in their budding years. Although many studies have been previously done on this subject, yet none have been done in Goa. Keeping this in mind, the current study was carried out in Goa Medical College to assess the perception and practice of self-medication amongst second year medicalstudents.
To conclude, there is no doubt about the role of self- medication in the healthcare services. Nevertheless, self- medication has to be within the scope and it ought to have restrictions to the kind of symptoms to be self-diagnosed and treated. The prevalence and practice of self-medication in our study was alarming in both groups. Fever, headache, cough and cold were the most common indications leading to self-medication. Antipyretics and analgesics were the most commonly used medicines for self-medication. The use of antibiotics was also found to be very high amongmedicalstudents. This creates a concern over the antibiotic use among the medicalstudents and doctors because of their medical knowledge about drugs and diseases, which could also contribute to antimicrobial resistance. It is the need of the hour to create better awareness amongmedical and non-medical population regarding the use of drugs for self-medication, to implement strategies and guidelines to prevent the dispensing of medicines without any prescription which would remain as the cornerstone for reducing the practice of self-medication.
The study was conducted to find out various aspects of self-medication (SM) amongmedicalstudents. A prospective, cross-sectional, questionnaire-based study was carried out among 285 medicalstudents of 2 nd , 3 rd and 4 th year. Data were collected and analyzed for counts and percentage. Students reported self-medication in the last one year were 76 % and the frequency of SM was more in final year students.35% believed that they practice SM as the complains were mild in form, followed by quick relief of symptoms and time saving. Abdominal pain along with headache and fever were the most frequent causes for SM in our study. While commonly used drugs were analgesics and antipyretic along with antacids and antibiotics. Most common source for acquiring these medicines were pharmacist shops followed by unused medicines from previous prescription and unsold physician sample.
In present study adherence in diabetic patients are higher in age group 18-40years. This finding is line with the most of previous studies Hadiyah TM et al, (Sudan) reported higher adherence among people above 60years of age and in 30-39years. 17 Elsous A et al, reported old age (≥60years) was a predictor of good adherence, but the finding was not statistically significant. 18 It is also important to note that the social support system among the families to take full responsibility for regular medications for the elderly is contributory to good medication adherence. However, diabetes drug therapy is more complex, and patients are required to have more composite cognitive skills to be able to understand the prescribed drug therapy and to adhere to treatment for diabetes mellitus which could be the reason for adherence in age group of 18-40 years as shown in present study.
Figure 3: Result of attitude about counterfeit drug (n=80).
Counterfeiting is public health problem in developing as well as developed countries. The poor medicine quality directly evils patients and produce harmful impact on healthcare systems. Based on previous studies, the median prevalence of counterfeit medicines was 28.5% that varied from 11% to 48% in individual studies. 5 The global market for counterfeit drugs is estimated to be at US $200 billion in which India repercussions worth of 15 billion dollars. 6 There are several reasons for counterfeit medication, the most common are lack of pharmacies or health clinics in rural area, cost effective (relative cheaper), poor legislative and regulatory framework for monitoring drug quality and imminent awareness of society towards its adverse effect. 7,8