Sunscreen Use among Medical Undergraduate Students in a Medical College: A Descriptive Cross-sectional Study.

INTRODUCTION: Unprotected sun exposure could cause tanning, burning, hyperpigmentation, skin aging, and even skin cancer. Regular sunscreen use is a safeguard and a primary preventive strategy against sunlight-related damages. This study aims to find out the prevalence of sunscreen use among medical undergraduate students of a medical college of Eastern Nepal. METHODS: A descriptive cross-sectional study was conducted among the current medical undergraduate students of 2 medical colleges in Nepal on sunscreen use from September 2020 to October 2020. Convenience sampling was done to reach the sample size of 300. Data collection was done after taking ethical approval from the Institutional Review Committee (IRC/1778/020). Data analysis was done by using Statistical Package for the Social Sciences version 11.5 software. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: The prevalence of sunscreen users was found to be 227 (75.67%) (70.81-80.52 at 95% Confidence Interval) among whom only 35 (15.41%) were regular users. Majority 144 (63.43%) applied sunscreen only on the face, 72 (31.71%) considered reapplication, and 155 (68.2%) knew the Sun Protection Factor value of their sunscreen. Cosmetic sunscreen was considered by the majority of the users 151 (66.51%). Greasy feeling 73 (100%) was the reason for avoiding sunscreen use amongst the non-users 73 (24.34%). CONCLUSIONS: The prevalence of sunscreen users among medical undergraduate students from our study was higher than other studies conducted in similar settings.

Pharmacovigilance of Antiretroviral Drugs at B.P. Koirala Institute of Health sciences.

BACKGROUND: Antiretroviral drugs are lifeline for patients living with HIV. Adverse drug reactions can compromise the compliance to antiretroviral therapy. The objectives of the study were to estimate the prevalence of adverse drug reactions and to assess its risk factors in patients living with HIV and receiving antiretroviral therapy. METHODS: A prospective cohort study was conducted among 496 patients living with HIV at B.P. Koirala Institute of Health Sciences for a period of one year. Adverse drug reactions were evaluated based upon clinical history, clinical examination and investigations. RESULTS: Majority of patients were of 31-45 year age group (58.1%) and on first-line antiretroviral therapy regimen (94.3%). Total of 240 adverse drug reactions were documented. Prevalence of adverse drug reaction was 34.7%. Skin rash, anemia and nausea and vomiting were the three most common adverse drug reactions. The adverse drug reactions were more common in patients having non-communicable diseases, chronic co-infections, taking more than 3 non-HIV drugs, second and third-line antiretroviral regimen and it was statistically significant (P-value < 0.05). CONCLUSIONS: Prevalence of adverse drug reaction was high in the patients living with HIV. Age, gender, co-infections, non-communicable diseases, taking more than three non-HIV drugs and second and third-line antiretroviral regimen were identified as possible risk factor for occurrence of adverse drug reactions and their prior identification is important to optimize the best suited antiretroviral regimen.

Prevalence of Substance Use among Undergraduate Students in a Medical College of Nepal.

INTRODUCTION: The consumption of substances is a common practice among the medical students and their use might reduce educational and clinical performances as well as judgment of the students. This study aims to find out the prevalence of substance use among medical students in BP Koirala Institute of Health Sciences. METHODS: A descriptive cross-sectional study was carried out among medical students of BP Koirala Institute of Health Sciences from 15th September 15th to December 15th 2018 after obtaining ethical approval from the Institutional Review Committee (Ref: 1394/017). The study was conducted among 326 medical and dental students from first to fifth year by using the stratified sampling method. A self-reported questionnaire was developed which included types, frequency, duration, age to first use, and motives for the use of different substances. Data was analyzed using Statistical Package for Social Sciences version 11.5. RESULTS: The prevalence of substance use among medical students of BP Koirala Institute of Health Sciences was 196 (61.4%) at 95% Confidence Interval (56.05-66.75%). Among substance use, the use of alcohol 190 (59.6%), tobacco 90 (28.2%), and marijuana 38 (11.9%) was more prevalent. One hundred forty four (45.2%) male students used more substances as compared to 52 (16.3%) female students. Fun sake or partying 131 (68.9%) was the main motivation of the students to use substances. CONCLUSIONS: The overall substance use among medical students was high compared to other studies. Alcohol was the most common substance misused by the student followed by tobacco and marijuana. Proper counseling and awareness programs about the potential risk of substances are recommended for the betterment of the students.

Effect of root-extracts of Ficus benghalensis (Banyan) in pain in animal models.

INTRODUCTION: According to the WHO, 70-80% population in developing countries still relies on nonconventional medicine mainly of herbal origin. Even in developed countries, use of herbal medicine is growing each year. Pain is an unpleasant feeling often caused by intense or damaging stimuli. Traditionally, different plant parts of Ficus benghalensis are claimed to have several analgesic properties. Few scientific evidences support these uses. Interestingly, still others contradict these uses. It was shocking to find very scarce scientific studies trying to solve the mystery. MATERIALS AND METHODS: It was a quantitative experimental study in Swiss albino mice of either sex. Sample size was calculated using free sample size calculating software G*Power version 3.1.9.2. Hot-plate test and tail-flick test were central antinociceptive paradigms. Writhing test was peripheral model for pain. Test drugs were aqueous root extracts of F. benghalensis at 100 mg/kg and 200 mg/kg mouse weight prepared by Soxhlet method. Suitable negative and positive controls were used. The experimental results were represented as mean ± standard deviation statistical level of significance was set at P < 0.05. For calculation, parametric test - one-way analysis of variance (ANOVA) or nonparametric test - Mann-Whitney U-test was appropriately used. RESULTS: Hot-plate reaction time at 100 mg/kg (13.64 ± 1.30 s) and 200 mg/kg (10.32 ± 2.23 s) were nonsignificant (P = 0.425 and P = 0.498, respectively) compared to negative control (11.87 ± 1.92 s). One-way ANOVA revealed nonsignificant (P = 0.178) between-group comparison in mean tail-flick reaction time. Test drug at 200 mg/kg produced statistically significant more writhing (36.00 ± 14.85 in 10 min) than negative control, normal saline (11.83 ± 12.43 in 10 min) or the positive control, Indomethacin (3.50 ± 5.21 in 10 min), P value being 0.031 and 0.003, respectively. CONCLUSION: Aqueous root extracts of F. benghalensis at 200 mg/kg produces statistically significant writhing.

Drug utilization pattern and effectiveness analysis in diabetes mellitus at a tertiary care centre in eastern Nepal.

An observational follow up study conducted for one year at a tertiary care centre in 154 newly diagnosed diabetes mellitus patients is presented. The aims of the study were to determine the demographics, prescribing patterns, drug cost and analyze effectiveness of different therapies. Effectiveness of therapies were analyzed in patients achieving glycemic control by Wilcoxon signed- rank test. Majority of patients (n = 114) fell into the middle age strata of 35-64 years and 97% were type 2 diabetics. A total of 282 prescriptions were screened that included antidiabetics and other drug categories. Mean number of drugs per prescription sheet was 1.83 +/- 1.31. Oral hypoglycemic agents were advised to 64% of the patients. The prescribing frequency of biguanides (24.5%) was more than sulphonylureas (19.9%). Only 67 patients followed up for 3 months +/- 15 days, of which 46 achieved glycemic control. The biguanides only group (p = 0.002) and combination therapy of biguanides and sulphonylureas group (p = 0.005) were the highly effective therapies, as their p values of fasting blood glucose levels on follow up were the lowest. Nearly 90% of patients on combination therapy achieved glycemic control. In conclusion, this study reflects the therapeutic approach followed in diabetes mellitus as optimal. Future research on a larger patient population is warranted to evaluate existing patterns of therapy for sound practice and quality of care.

Polymorphonuclear leukocyte function in type-2 diabetes mellitus patients and its correlation with glycaemic control.

Infection is an important cause of morbidity and mortality in diabetic patients. Chronic hyperglycaemia impairs host defense mechanism such as cell mediated immunity, polymorphonuclear leukocyte (PMNL) function, antibody formation etc. PMNL serves as bodies first line of defense against various infections. The present study was undertaken to establish a correlation between impaired PMNL function, blood glucose levels and its improvement with good glycaemic control with glibenclamide and glimepiride, with special reference to parameters such as respiratory burst and O2(-) and H2O2 production by diabetic neutrophils.

Drug dose calculation need to be drilled.

A study was conducted to establish the knowledge of correct dose calculations and conversion between mass concentration, dilution and percentage concentrations amongst medical and paramedical personnel handling patient, with life saving support system. A questionnaire was prepared having five standard questions to be answered in ten minutes by medical house officers and nurses. Results of the study suggested that the knowledge of correct dose calculations of both the medical and paramedical personnel needs to be improved to impart best possible management to the critically ill patients.

Current status of prophylactic use of antimicrobial agents for caesarean section in a tertiary care teaching hospital in eastern Nepal.

A prospective assessment of the current status of prophylactic use of antimicrobial agents (AMAs) for caesarean section deliveries at BPKIHS, Dharan, Nepal was done. Data was collected by systemic random sampling of 349 in patient case sheets. The prevalence of use of ampicillin either alone or in combination with metronidazole was noted in both the elective and non-elective groups, either in the hospital or at discharge, while only 7.0-9.0% of patients receivedAMAs other than ampicillin. Ampicillin has been reported to be an effective AMA in reducing post-partum endometritis and our observation also corroborates with this finding.

Student's critical appraisal on the evaluation of analgesics in laboratory animal verses simulated clinical trail.

Effective feedback is an integral part of medical education in helping the medical students to reach their maximum potential. Without feedback mistakes may go uncorrected which results poor performances of learners as well as tutors. At present teaching learning methodology used in many medical colleges includes lectures, tutorials, practical and occasionally small groups teaching and case discussions. The curriculum of undergraduate medical and dental students of BP Koirala Institute of Health Sciences, Dharan, Nepal is need based, integrated, co mmunity oriented, partially problem based. The practical lessons are an important part of Pharmacology curricula of undergraduate courses. So the aim of this study was to evaluate the student opinion towards animal experimentation as well as simulated clinical trial (SCT) on analgesics in terms of understanding the objectives. To conduct the study a semistructure questionnaire were provided to 2nd years MBBS and BDS students to obtain their view. Of the 164 questionnaires 154 students submitted completed questionnaire. On analysis of the feedback, it was observed that 77.9% students liked animal experiments and most of them wee happy with simulated clinical trial. The majority of the students 74.1% favoured both exercises for improved understanding of the subject and 66.2% agreed the sequential sessions. So the study concludes with the view that sequential sessions of laboratory experiments as well as SCT are required for a rectified learning of Pharmacology.