Knowledge, Attitude, and Practices About Research Integrity and Scientific Misconduct Among the Faculty and Medical Postgraduates Working in Medical Colleges in North Karnataka and Central India: A Cross-Sectional Online Survey.

Introduction Research integrity is an active adherence to the ethical principles and professional standards essential for the responsible practice of research. Research or scientific misconduct stands like child abuse today. The survey of National Institutes of Health (NIH)-funded scientists calculated an absolute minimum of 2325 incidents of scientific misconduct per year. A report has also shown that Iran (6.60), India (5.68), Turkey (5.38), South Korea (3.59), and China (2.00) had higher ratios of publication misconduct to distrust data or interpretations than other countries. Hence, to determine the knowledge, attitude, and practices (KAPs) of the research integrity/scientific misconduct among the faculty and postgraduates working in the medical colleges in North Karnataka (NK) and Central India (CI), this study has been carried out. Methods It is a web-based, cross-sectional study carried out with the use of Google Forms (Google, Mountain View, California). A pretested, unstructured questionnaire consisting of 25 questions was posted in the way of a link to the faculty and postgraduates working in various disciplines within the colleges of NK and CI either by using an e-mail or other social platforms like WhatsApp. Institutional Ethics Committee approval was obtained in both regions before conducting the survey. Results A total of 146 participants responded to the e-questionnaire posted to them. Participants from CI displayed better awareness in several areas compared to NK. Citing articles and/ or materials that have not been read is the common questionable research practice (QRP) they have come across, as mentioned by participants in both groups. Discussion The study reveals a moderate level of knowledge and variable attitudes toward research integrity. The "publish or perish" culture is a major contributor to misconduct. Training and awareness programs are needed to enhance ethical research practices. Conclusion This study highlights the need for improved education and policy implementation to uphold research integrity in medical colleges, emphasizing the role of academic culture in shaping ethical research practices.

Evaluation of factors that act as barriers in conducting academic trials - An investigator's perception.

Background: Academic trials are essential in investigating health research questions relevant to the society. Only a few leading research institutions in India have been engaged in academic trials. Thus, there is a need to understand what factors dampen the spirit of the academician in conducting academic clinical trials. Aims and Objectives: The aim of the study is to evaluate the investigator's perception of obstacles to carrying out academic trials and to identify factors that will motivate investigators in conducting academic trials. Materials and Methods: We conducted a prospective observational study in a tertiary care hospital for 6 months. Faculty members working in academic institutes were selected. A structured questionnaire was designed for the study and administered using google forms. Responses were taken on a Likert scale. Validity and reliability assessments were carried out. Mann-Whitney test was applied to assess differences between demographic groups. P <0.05 was considered significant. Results: Most of the participants rated applying for research grants (76%), obtaining funding for the study and making arrangements for compensation for trial-related events (75%) as extremely challenging. We found that the degree of challenge is significantly lower in the faculty members who conducted clinical trials in the past as against those who did not (P = 0.00069). We also found that the degree of challenge is significantly higher in the faculty members with <10 years of experience than those with >10 years of experience (P = 0.00001). Conclusion: Thus, to conclude the challenges faced by investigators were at multiple levels, most common being applying for research grants and making arrangements for the funds for payment towards participation or study-related injury. Faculty members with exposure to conducting clinical trials and with experience of more than 10 years had perceived a reduced degree of challenges.

Analysis of Cutaneous Adverse Drug Reactions (ADR) Reported at an ADR Monitoring Center of a Tertiary Care Teaching Institute in Central India.

Background Cutaneous adverse drug reactions (ADRs) are among the most frequent ADRs. Knowledge of the pattern of cutaneous ADRs (CADRs) and causal drugs helps prevent and reduce the incidence of CADR, which in turn reduces the incidence of hospitalization and expenses for the patient. Objectives To analyze CADR according to demographic profile, morphological pattern, causative drugs, severity, and outcome in patients suffering from CADRs. Materials and methods Retrospective data analysis was conducted in the Adverse Drug Reaction Monitoring Centre (AMC) of the tertiary care teaching institute between February 2020 and September 2023 under the Pharmacovigilance Program of India (PvPI). All ADRs reported were analyzed based on the following parameters: total number of ADRs reported, number of CADRs, information related to demographic parameters, the clinical presentation of CADRs, and suspected medication. Causality assessment was done using the World Health Organisation-Uppsala Monitoring Centre (WHO-UMC) scale. Severity was assessed using a modified Hartwig and Seigel scale. Results A total of 125 CADRs were analyzed. Considering the gender-wise distribution, 65 females and 60 males suffered from CADR. The most common drug category responsible for CADRs was antimicrobials (63.2%), followed by topical agents (12.8%). Maculopapular rash (33.6%) was the most common presenting symptom, followed by itching (27.2%). Few patients suffered from serious CADRs such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).  Conclusion A wide clinical spectrum of CADRs ranging from maculopapular rash to fixed-drug eruption to serious SJS was observed in our study. The most common causative agents for CADRs were antimicrobials, followed by topical agents and NSAIDs. For early diagnosis and management of CADRs, it is critical to have data on the potential cutaneous adverse effects of commonly used drugs, to educate the patients regarding common early symptoms of drug reactions (e.g., erythematous rash, edema, urticaria, mucosal erosions, itching, burning of skin, etc.), and to monitor the patient, especially during the start of therapy. To ease the burden of CADRs, a therapeutic plan of anticipating, avoiding, recognizing, and responding to ADRs should be implemented.

Effect of Ramipril on Cardiac Autonomic Neuropathy in Patients With Type II Diabetes Mellitus.

Background Cardiovascular autonomic neuropathy (CAN), an important form of DAN is caused by the impairment of the autonomic nerve fibers that innervate the heart and blood vessels and leads to abnormalities in cardiovascular dynamics. The earliest finding of CAN, even at the subclinical stage, is a decrease in heart rate variability (HRV). Objective The objective is to assess the effect of ramipril 2.5mg once daily on cardiac autonomic neuropathy in type II DM patients as an add-on to a standard antidiabetic regimen for a duration of 12 months. Materials and methods A prospective, open-label, randomized, parallel-group study was conducted on type II DM with autonomic dysfunction. Patients in Group A received tablet ramipril 2.5mg daily along with the standard antidiabetic regimen which consist of Tab Metformin 500mg twice a day and Tab Vildagliptin 50mg twice a day and group B received only the standard antidiabetic regimen for 12 months. Results Among 26 patients with CAN, 18 patients completed the study. After one year in group A, Delta HR value increases from 9.77±1.71 to 21.44±8.44 and the E:I ratio (ratio of the longest R-R interval during expiration and shortest R-R interval during inspiration) improved from 1.23±0.35 to 1.29±0.23 signifying significant improvement in parasympathetic tone. Results of the postural test showed significant improvement in SBP. Analysis of HRV by time domain method showed that the standard deviation of RR (SDRR) interval and Standard deviation of differences between adjacent RR interval (SDSD) value increased significantly in group A. Analysis of HRV frequency domain indices showed that LFP:HFP ratio improved after treatment in ramipril group indicating improvement in sympatho-vagal balance. Conclusion Ramipril improves parasympathetic component more as compared to sympathetic component of DCAN in type II DM. Ramipril could be a promising option having favorable long-term outcomes in diabetic patients especially when treatment begins at subclinical stage.

Association of funding and conflicts of interest on outcomes reported in published studies of Covid-19.

BACKGROUND: An outbreak of the Covid-19 has led to substantial mortality globally. The entire world is carrying out studies to understand the pathophysiology, clinical features, diagnosis and treatment of Covid-19. We investigated the possible association of type of funding, corporate or academic, and conflict of interests on the outcomes reported in clinical trials on Covid-19. METHODS: Studies containing the keywords "clinical trial" AND "Covid 19" or "Corona" were located by a search on PubMed published between September 2019 to August 2021. Filters were used to select only papers in the English language and on "humans". The data were analysed using descriptive statistics and the Chi-square test. RESULTS: We found a significant association between the existence of a conflict of interest and reporting of a positive outcome (X2 value = 18.751, p less than 0.001). We also found a significant association between industry funding and reporting of a positive outcome (X2 value = 18.041, p less than 0.001). CONCLUSION: We conclude from this study that the presence of conflict of interest and pharmaceutical industry funding is associated with reporting a positive outcome.

Assessment of knowledge, attitude and practice towards COVID-19 among paramedical staff in Central India: A cross-sectional, online survey.

BACKGROUND: Knowledge of a disease can influence paramedic's attitudes and practices, and incorrect attitudes and practices directly increase the risk of infection. Understanding paramedic's knowledge, attitudes, and practices (KAPs) and possible risk factors helps to predict the outcomes of planned behavior. To assess KAP regarding COVID-19 through Google form among paramedical staff at tertiary care teaching institutes of central India. MATERIALS AND METHODS: A cross-sectional, multicentric, questionnaire-based study was conducted from May 2020 to August 2020 among 230 paramedical staff from two tertiary care teaching institutes through Google form. Data were analyzed by Chi-square test and parametric test using GraphPad prism software version 5.0. RESULTS: All participants had knowledge about symptomatology of COVID-19. However, significantly more participants in nursing cadre know about definition of close contact. The mean knowledge score was 4.84 ± 0.6. The mean score for attitude was 4.48 ± 0.83. Overall, 54.78% of paramedical staff follow correct prevention strategies. Of them, significantly more nursing staff correctly practice infection control measures upon arrival of COVID-19 patients (P = 0.033). There was a significant difference among both groups regarding wearing of appropriate personal protective equipment while transporting/accompanying patients who are confirmed with COVID 19 (P = 0.009). The overall score for practice is 3.97 ± 1.03. The practice score was significantly better in nursing cadre as compared to nonnursing cadre (P = 0.038). CONCLUSION: Majority of the participants had good knowledge and positive attitude. Nursing cadre follows better preventive practices as compared to nonnursing cadre while performing COVID-related duties. Considering these facts, dodges responsible for poor practices should be identified and resolved so that India will be able to conquest the battle against the disease.

Comparison of self-medication practices with analgesics among undergraduate medical and paramedical students of a tertiary care teaching institute in Central India - A questionnaire-based study.

CONTEXT: Inappropriate self-medication can increase chances of adverse drug reactions, disease aggravation, or drug interactions. Analgesics are most commonly used as self-medication. AIMS: The aim of this study was to evaluate and compare analgesic self-medication practices among medical and paramedical undergraduate students of a tertiary care teaching institute in Central India. MATERIALS AND METHODS: A cross-sectional, observational study was conducted in 216 undergraduate medical (MBBS and BDS) and paramedical (occupational therapy/physiotherapy and BSc nursing) students. A predesigned, self-developed, semi-structured questionnaire was used. STATISTICAL ANALYSIS: The Chi-square test was used for testing statistical significance. RESULTS: The overall prevalence of self-medication with analgesics was 83.33%. Self-medication was significantly high among medical students as compared to paramedical students (P = 0.003). Significantly more medical students were aware about adverse drug reactions of analgesics as compared to paramedical students (P = 0.019). The most common source of information about drugs was previous prescription (58.33%), followed by media including the Internet (53.70%). The most dominant symptom compelling self-medication was found to be muscular pain (42.12%), followed by headache (36.57%). 54.16% of the students revealed that self-medication provides quick relief from pain. The most commonly used analgesic was paracetamol (82.40%), followed by diclofenac (22.68%). A significant number of paramedical students do not know exactly what precautions should be taken while taking analgesics (P = 0.002). CONCLUSIONS: Medical students are more indulged in self-medication practices with analgesics. Paramedical students need to be educated regarding safe use of analgesics.