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-medicationamongstsecondyearmedicalstudents.
Self-medication is a common practice among a group of health workers in Nigeria, according to Ehigiator O et al. 10 Undergraduate medical 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 among undergraduate medical 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-medication among the undergraduate medical and dental students of the Pacific Medical College, Udaipur, Rajasthan, India.
Different OTC antidiarrhoeal drugs are available in medicine shops. Majority of students used ORS as the selfmedication. Many patients with sudden onset of diarrhea have a benign and self limited illness requiring no treatment or evaluation. In severe cases, dehydration and electrolyte imbalances are the principle risks, particularly in infants, children and frail elderly patients. Oral rehydration therapy is therefore a cornerstone for patients with acute illness resulting in significant diarrhea. This is of particular importance in developing countries, where the use of ORS therapy saves many thousands of lives every year
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.
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 selfmedication among students 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.
2. Material and Method
The present study is a cross sectional study that included 80 final years under graduate medicalstudents, regularly attending in-patient and out-patient clinics along with operation theatres. It was conducted at tertiarycarehospital and teaching institute after ethical clearance. Selection was done on random basis and identities of participants were decoded. The participants who gave consent were provided with a pre-tested questionnaire that included several questions on knowledge attitude and practices on hospital infection prevention, skin disinfec- tion and hand washing, waste disposal, universal precautions and nosocomial infection. Each of the fields was given a score, the KAP score. The questionnaire was designed such that it included a series of items divided in the following sec- tions: 1) knowledge about the frequency of the HAIs and the disinfection prac- tices; 2) attitudes towards the utility of guidelines/protocols and perception of the risks of acquiring or transmitting HAIs; 3) practices and behaviors with an- tisepsis/disinfection procedures; and 4) sources most frequently used to receive up-to-date information about disinfection procedures. The series of answers to the knowledge questions about disinfection practices were arranged by asking respondents to indicate their agreement with true or false statements on a three point Likert-type scale ( i.e. , agrees, uncertain, disagrees), and about the fre- quency of the HAIs were as “yes” and “no” choices. Responses to all items as- sessing attitudes evaluated relating level of agreement or disagreement were on a ten-point Likert-type scale ranging from “1” to “10”, meaning “not likely at all”
Figure 2: Students preference for teaching aidsto various parameters.
However to demonstrate the clinical conditions (70.65%) and covering more subject per lecture (59.23%) our students preferred PPT teaching. The overall preference of PPT teaching was only 16% in our study. The reasons to dislike PPT are that the power failure can interrupt lectures and also takes longer time to set up the projection. Here the students are passive observers rather than active participants. Our study can be compared with the study of Banerjee I et al where in 60% of medicalstudents preferred chalk and board and 20% preferred to LCD slides. 14 Novella ELB et al, another study showed that the traditional chalk and board was superior teaching method. 15 The chalk and board method was preferred as students felt that it increases their co-ordination with teacher, they’ll get time to note down the points and also to understand the content which is to be taught which do not happen in power point presentations. 19% of students preferred a combination of teaching aids where in earlier studies done by Bennal AS et al scored 54.9%. 16 OHP was the least preferred teaching aid for all parameters in our study. The reasons for liking blackboard are that it encourages students to follow the pace of the teacher which has natural breaks and pauses and more importantly power failure will not interrupt the lecture.
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 undergraduate students 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.
As previously described there are many influencing factors such as education, family, friends, advertisement etc., which affect pattern of self-medication. Education plays a significant role in its prevalence. 6 This study has found more occurrence of self-medication in secondyearstudents which was around 40%. This may be because of studying pharmacology subject in secondyear which was supported by other studies. 11,13 They are getting all information about drugs like their mechanism, uses, adverse drug reactions etc. In addition they are working up cases in the clinical subjects. All these factors may increase their knowledge as well their confidence level in Pharmacology. 18 This might encourage them to indulge in self-medication.
A comparative cross-sectional questionnaire-based observational study was conducted in Acharaya Shri Chander College of Medical Sciences and Hospital, Sidhra, Jammu, J and K in the month of April and May 2017. Institutional Ethical Committee approval was taken before commencement of the study. Two forty six undergraduate medicalstudents 118 students from 1 st year and 129 students from 2 nd year MBBS were included in the study to assess the extent of knowledge and awareness about the problem of antibiotic resistance The students who were not willing to participate in the study were excluded. Self-administered questionnaire was used to collect the data from respondents. The purpose of the study was explained and written informed consent was obtained from all the participants before being given the questionnaires. The questionnaire was developed based on the objective of the study and it was validated by conducting a pilot study on a sample of twenty undergraduate MBBS students from 1 st and 2 nd year who were excluded from the study.
Regarding source of information, the most common source of information was advice from the seniors followed by books, internet, old prescriptions and media. In Saudi population, pharmacists and doctors were the most common source of information as study done by Karami et al. 12 In ACGR Government Medical College, Nellore, old prescriptions and text books were the most common source of information. 14 Similar finding was observed among undergraduate students in a medical college in Kolkata. 19 Paracetamol was the most common drug used by third and fourth yearstudents in RIMS, Ranchi whereas in Nellore the most common analgesics used by fifth semester students was Diclofenac Sodium whereas seventh semester students used Paracetamol. 14 Among Saudi female students, total 88.3% reported use of analgesics among which 49.2% used Paracetamol. 20 In Nepal also about 82.7% adults of age group 20 and above residing in Chapapani - 12, Pokhara were using Paracetamol as OTC Analgesics. 1 Among Saudi population 73.4% used Paracetamol and 13.1% used ibuprufen 12 whereas in present study diclofenac sodium was the second most commonly used analgesic. Paracetamol is one of the most commonly used non-narcotic analgesic-antipyretic agent used with negligible anti inflammatory action. Recent evidence suggests that Paracetamol may act by inhibiting cycloxygenase 3 (COX 3) in CNS. COX 3 is involved in pain perception and fever but not in inflammation.
Background: The term Antimicrobial resistance (AMR) is used when a microorganism either bacteria, virus, fungus/parasite, no longer responds to a drug to which it was originally sensitive. Increased incidence of AMR directly reflects the increased antibiotic usage. Hence to promote the judicious use of antibiotics, undergraduate medicalstudents should be trained for proper prescription writing, dispensing & antibiotic usage. So this study was undertaken among the 2 nd year undergraduate students to assess their knowledge & attitude about antibiotic resistance and self-reporting practice related to antibiotic among the undergraduates so that it will help to plan & devise effective & tailored educational interventions if required.
Antimicrobial drugs are the greatest contribution of the 20 th century to therapeutics. These are most commonly used and misused drugs.  Injudicious use of these drugs has led to antibiotic resistance and has become a global health problem. In 2011 WHO has set a theme of world health day as “combat Antimicrobial Resistance: No action today, No cure tomorrow”, so as to create seriousness and awareness about antibiotic abuse and WHO has also stressed importance of undergraduate training.  One of the important causes for antibiotic resistance being irrational prescription, which includes unnecessary and over prescription, self- medication without doctor consultation and incomplete treatments, among these role of prescribers is considered vital. Mahajan et al, emphasized the fact that undergraduates who are future prescribers should be targeted about rational antibiotic prescription and undergraduation is the crucial period where importance of these issues should be stressed thereby in future they can adopt safe medication practices through their rational prescribing and also promote patient awareness on antibiotics.  There are so many interventions which will target the hospitals and practitioners to reduce antibiotic resistance and one among them is the educational campaign. 4 Prior to that, knowing studentsperception and knowledge about antibiotic resistance is also important so as to plan effective educational tool for them. Hence the present study was undertaken among secondyearmedicalstudents in order to assess their knowledge and attitude concerning antibiotic resistance and various practices related to antibiotic usage.
Department of Pharmacology, P. D. U. Government Medical College, Rajkot - 360001, Gujarat, India.
ABSTRACT: Introduction: Mental disorders account for nearly 12% of the global burden of disease. They are expected to become the second most important cause of disability in the near future. Medicalstudents remain under great academic pressure to pass internal and external exams which continuously keep them under pressure. It is also very important to know how students feel rather than to treat only those who visit clinicians. Undiagnosed mental disorders adversely affect physical wellbeing too. Objectives: The primary objective of this study was to evaluate the subjective presence of mental health disorder in undergraduate medical student. Materials and Methods: DSM -5 self- rated symptom measure tool was used to detect the presence of mental health domains. Presence of any symptom in level 1 was further assessed by measuring its severity in level 2. Results: Study detected 86% of students had felt disturbed mental health in the past two weeks. Males had a higher number of symptoms than females. Manic symptoms were most common followed by anxiety and depression. Mania and depression were most common in males and females respectively. Symptoms of isolation and dissociation were significantly present in the first year of undergraduate medicalstudents. The statistically significant negative correlation between age and presence of symptoms suggesting as age increase student learns manage academic pressure. Most of the student had none to slight severity in level 2.
resistance is rapidly developing and escalating. The awareness on its seriousness and significance is the first step of approach for hampering its spread. To undertake instructional and educational campaigns among the general population as well as among the health care personnel regarding antibiotic resistance, its dangerous consequences and prevention of its development and spread, to train undergraduate and postgraduate medical, pharmacy and nursing regarding proper prescribing, dispensing and use of antimicrobials, to carry out surveillance studies of knowledge , attitude and practice among the medical and paramedical professionals are various remedial steps suggested to overcome the problem of AMA resistance. 4 Antimicrobial resistance is a serious global problem of antimicrobial abuse and there is a growing consensus to urgently develop new strategies for prevention of resistance of bacteria to antimicrobial agents. 5 Improper use of antimicrobials leading to resistance is a because of numerous factors such as prescribers knowledge and experience, diagnostic uncertainty, prescribing on patient’s demand, seniors as a role model, drug promotional practices, overload of patients and negligence of proper prescribing, self- medication of patients. 6 Relatively few studies of knowledge, attitude and practice are published regarding antimicrobial resistance. So, it is worthwhile to assess the knowledge, attitude and awareness regarding antimicrobial stewardship in the tertiarycareteachinghospital.
The study was conducted to find out various aspects of self-medication (SM) among medicalstudents. 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 yearstudents.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.
Background: In the hospital, patients are often exposed to multiple proce- dures, invasive devices etc., increasing their chances of contracting such po- tential pathogens. Most of the time these potential pathogens exhibit multiple drug resistance. Aim: In view of the above factors, this study was undertaken to determine the rate of colonization of potential bacterial pathogens in the hands of final year MBBS undergraduate students. As per their clinical teach- ing curriculum, they visit the wards/ICU/OT, etc. on a daily basis. Method:
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- medication among medicalstudents 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
The administration errors in outpatients were not assessed in our study as their adherence to medications could not be monitored accurately.
However, medication adherence measures were also not followed. Majority of errors observed in our study were grouped under category C. Such errors reached the patient but did not cause any harm to the patient, as in case of dose omission, administration of drug at wrong time and splitting enteric coated tablets, combination drug products and controlled release tablets. For instance, nurse failed to administer escitalopram 10mg (Dose Omission) and administered risperidone 3mg at wrong time. Such errors reached patient but no patient suffered observable harm as a result of these errors as the nurse was immediately advised regarding the missed dose and administration of the drug at the right time by the pharmacist posted in the respective ward.
practices in our country remained uncharted. With this in mind, the present study was planned to determine the pattern of Self-medication practices, to find out the common ailments and common drugs used, reasons for Self-medication along with assessing relationship between the level of medical education and the Self- medication practices among medical undergraduates. On one hand, students become more and more cautious in practising selfmedication, knowing that irrational and inappropriate usage of them might be more harmful than useful, so they, even in situations of minor illnesses prefer taking any medication only after consultation from a qualified practitioner. On the other hand, they may become confident, and in most cases, overconfident, regarding their “bookish” knowledge and may start implementing selfcare. They may either become successful in this attempt boosting up their confidence levels, hence encouraging them for its continued use or even over-use, or may suffer such setbacks leading to a detrimental health or a diseased state. However, it is also recognized that self-medication must be accompanied by appropriate health information.