Impact of Multimodal Intervention on Empathy Levels in Medical Students: A Questionnaire-Based Study.

Background Empathy is essential for effective doctor-patient communication. It enables doctors to understand patients' emotions and concerns, facilitating personalized care and support. Empathy can be cultivated through various methods and training programs. Objective The study aims to assess the effectiveness of a multimodal intervention involving interactive lectures, peer role-play, and guided reflection in enhancing empathy levels among second-year medical undergraduate students in India. Methods This study utilized a questionnaire-based, pre- and post-test interventional design. Seventy-nine second-year medical students were included after obtaining their informed consent. The students received the intervention through an interactive lecture on communication skills, role-play on selected case studies, and guided reflection. The empathy levels were assessed using the Toronto Empathy Questionnaire (TEQ) before and after the intervention. The Mann-Whitney U test was utilized to compare pre-test and post-test TEQ scores. A univariate analysis of variance was conducted to explore the relationship between demographic variables and post-test TEQ scores. Statistical significance was considered at p ≤ 0.05. Results The TEQ score improved significantly (p=0.009) after the intervention. The univariate analysis indicated that gender, style of education, and place of residence did not have a statistically significant impact on post-test scores. Conclusion The study demonstrates that a multimodal intervention significantly enhances the empathy level of medical students, highlighting the potential of focused interventions to reduce gender disparities in empathy levels. There were no significant differences in empathy scores based on gender, place of residence, or schooling, suggesting the intervention's benefits may apply to all medical students.

Nursing Professionals' Awareness of Adverse Drug Reactions and Pharmacovigilance in an Institute of National Importance in India: A Cross-Sectional Study.

Background Globally, there is a growing concern about adverse drug reactions (ADRs) as they can lead to increased hospital admissions and healthcare expenses, lower patient satisfaction with treatment outcomes, and even fatalities. Pharmacovigilance is crucial for minimizing the risks associated with drug therapy, but underreporting of ADRs is a prevalent issue. Nursing professionals are an important stakeholder in ADR reporting, as they are often the first point of contact for patients to identify and report adverse drug reactions. Objectives The objectives of the study were to evaluate the knowledge and practices of nursing professionals regarding ADR reporting in a tertiary care teaching institute and the factors influencing their knowledge of ADR reporting. Methodology This was a cross-sectional study involving 275 nursing officers at AIIMS Raebareli, who gave their informed consent and completed a questionnaire on demographics, knowledge, and practice domains. Multiple linear regression analysis was used to compare independent variables' influences on knowledge scores. SPSS version 26 (IBM Corp., Armonk, NY, USA) was used for statistical analysis. Results The study revealed that the mean knowledge score was 6.378 (total score of 13), with a standard deviation of 2.299 (95% CI 6.10-6.65). About 50.18% of the participants had a knowledge score below 6.5. Multiple regression analysis revealed that working experience, female gender, working in an emergency department, and previous training on ADR reporting significantly influenced the knowledge scores. Conclusion The study found that nursing professionals had limited awareness about ADR reporting, even though they worked at an Institute of National Importance. Based on the findings, it can be concluded that there is a need for improved education and training on ADR reporting and to address barriers to reporting, such as a lack of awareness about reporting procedures, and alleviate the fear of legal consequences.

Efficacy of COVID-19 vaccines: a systematic review and network meta-analysis of phase 3 randomized controlled trials.

Several vaccines have been approved for the prevention of COVID-19. However, no head-to-head trials comparing their clinical efficacy have been performed. This network meta-analysis aims to identify those, among the competing existing vaccines, conferring the maximum protection against COVID-19. A literature search was done in Medline (via PubMed), Embase and Cochrane Library databases for phase 3 randomized controlled trials evaluating the efficacy of different COVID-19 vaccines. Search results were screened and eligible studies were included to perform a network meta-analysis in software 'R' version 4.1.2 using a random effect model. Cochrane's 'Risk of Bias tool (RoB2)' was used for quality assessment. Raw data from the included studies was used for network meta-analysis. Assessment of inconsistency was not possible as no study compared two or more vaccines directly. A forest plot for indirect comparison of various COVID-19 vaccines was obtained. Rankogram and 'P' scores were obtained to rank the vaccines based on the indirect evidence of their comparative efficacy. A total of 17 randomized controlled trials evaluating the efficacy of 16 COVID-19 vaccines, were included in the network meta-analysis. A total of 361,386 participants was included in this network meta-analysis. Overall risk of bias among included studies was of 'some concern'. All the COVID-19 vaccines had a statistically significant reduction of risk for contracting symptomatic SARS-CoV-2 in comparison to the placebo, however, the maximum protection (RR 0.05) was with BNT126b2. The indirect comparison also revealed BNT126b2 vaccine confers the highest protection against symptomatic SARS-CoV-2 infection in comparison to all others included, with a 'P' score of 0.9771 followed by mRNA-1273, rAD26 & rAD5 and NVX-CoV2373. The evidence generated from this network meta-analysis indicates the good efficacy of all the included vaccines in preventing symptomatic COVID-19 as compared to placebo. The BNT126b2 vaccine was found to provide the highest protection against symptomatic SARS-CoV-2 among all included followed by mRNA-1273, rAD26 & rAD5, NVX-CoV2373 and others.

Efficacy and Safety of Oral Diclofenac Sustained release Versus Transdermal Diclofenac Patch in Chronic Musculoskeletal Pain: A Randomized, Open Label Trial.

INTRODUCTION: To compare the efficacy, safety, and tolerability of transdermal patches of diclofenac sodium with oral diclofenac sustained release (SR) in patients of chronic musculoskeletal MSK pain conditions. MATERIALS AND METHODS: The eligible patients were given either transdermal diclofenac patch or tablet diclofenac SR. Pain was assessed at 2 and 4 weeks using a visual analog scale. Adverse events were recorded. Patients with 18-65 years old of either gender with score of ≥4 on a 11-item numeric rating scale-numeric version of visual analog scale for pain with diagnosis of primary osteoarthritis (OA) of the knee or hand of at least 3 months duration, with independent radiological confirmation of OA or having pain associated with other MSK conditions such as soft-tissue rheumatism, cervical and lumbar back pain, and fibromyalgia, of at least 3 months duration were included in this study. RESULTS: Transdermal diclofenac diethylamine patch and tablet diclofenac sodium sustained release (SR) do not significantly differ in the reduction of numerical rating scores at the end of 4 weeks (P = 0.8393). CONCLUSION: Transdermal diclofenac was equi-efficacious as tablet diclofenac sodium SR in reducing pain due to chronic MSK pain conditions.

Study of Cholesteryl Ester Transfer Protein (CETP) I405v Genotype and Its Association with Lipid Fractions in Myocardial Infarction Patients: A Case Control Study.

OBJECTIVES: We determine the significant relation of HDL cholesterol and total cholesterol/HDL cholesterol between CETP I405V genotypes and activity of CETP. CETP is an essential for transfer of cholesterol ester to the liver from peripheral tissues which facilitating its transfer to TG rich VLDL. Reduction activity of CETP I405V may associate with genotypes of CETP I405V. This study is undertaken to assess the presence and impact of CETP I405V genotype in our population. MATERIALS AND METHODS: In this study 100 acute myocardial infarction patients and 100 normal age & sex matched healthy individuals were included. Serum Lipid profile was estimated by using universal standard methods whereas CETP I405V genotype was studied by ARMS PCR. RESULT: There is presence of CETP 405Val genotype both in patient as well as in control group. RESULTs show that HDL cholesterol (p<0.0001) and ratio of total cholesterol/HDL cholesterol are significantly (p<0.0043) associated with Val/Val genotype. In addition to that the CETP I405V genotype is associated with inhibition of CETP activity with higher HDL-C level and decreased total cholesterol/HDL cholesterol ratio. CONCLUSION: Our results show that the CETP I405V genotypes are very much significantly determinant of HDL cholesterol in patients with CHD.

Impact of long term Yoga practice on sleep quality and quality of life in the elderly.

BACKGROUND: Sleep disturbances and decline in the physical functionality are common conditions associated with aging. Pharmacological treatment of sleep disturbances can be associated with various adverse effects. Short term trials of Yoga on sleep have shown beneficial effects. OBJECTIVES: To evaluate the effect of long-term Yoga exercises on sleep quality and quality of life (QOL) in the elderly. MATERIALS AND METHODS: This was a cross-sectional study in which data were collected from elderly people aged 60 years or more living in Nagpur city. We employed two types of survey questionnaires: Pittsburgh sleep quality index (PSQI) and QOL Leiden-Padua (LEIPAD) Questionnaire. A total of 65 elderly men and women who signed an informed consent and completed questionnaires were included in the study. Sleep quality score PSQI and QOL (LEIPAD Questionnaire) score of the study group were evaluated and compared with the control group using Mann-Whitney U test. RESULTS: Total PSQI score in Yoga group was lower than that of the control group. Also various QOL scores of the Yoga groups were higher than the control group. CONCLUSION: Addition of regular Yoga exercises in the daily routine of elderly people can help to achieve good sleep quality as well as improve the QOL.

The Prevalence Of ß-Thalassemia Mutations in South Western Maharashtra.

Thalassemia has been recognized by the World Health Organization as important inherited disorders principally impacting on the populations of low income countries. In this report, the prevalence of common ß-thalassemia mutations in India was defined in 126 ß-thalassemia carrier subjects in a western Indian population mainly from the south-western Maharashtra. The six most common ß-thalassemia mutations were detected, which included IVS I-5 (G-C), IVS I-1 (G-T), codon 8-9 (+G), codon 41/42 (-TCTT), Codon 15 (G-A), and 619 bp deletion at 3' end of ß-globin gene. These mutations accounted for 93.66 % in 126 ß-thalassemia carrier subjects and 6.34 % remained uncharacterized. Out of 126, 82 (65.07 %) showed the most common (prevalent) type of mutation, IVS I-5 (G-C), followed by IVS I-1 (G-T) showed by 12 (9.52 %) subjects. Three (2.38 %) subjects showed 619 bp deletion, codon 8/9 (+G) and codon 15 (G-A) mutations were present in eight subjects each (6.34 %). Only five (3.96 %) subjects showed codon 41/42 (-TCTT). There were eight (6.34 %) subjects where mutation was not any of the six mutations studied. This study provides the pattern of ß thalassemia mutations from south-western Maharashtra, which will help to prevent ß-thalassemia using prenatal diagnosis and proper counseling.

Effect of information, education and communication intervention on awareness about rational pharmacy practice in pharmacy students.

BACKGROUND: There is a growing indifference among the pharmacy practitioners towards their duty as information providers to the patients. The patients do not always get enough desired information about proper use of medicines from the prescribers also. This contributes to improper use of medicines by the patients. OBJECTIVES: To bring about awareness about rational pharmacy practice in pharmacy students for better service to the patients. MATERIAL AND METHODS: The final year students of Bachelor of Pharmacy (B. Pharm) from four colleges of Nagpur were enrolled for the study after informed consent. Their base knowledge was assessed through a written test which comprised of 27 objective questions related to rational pharmacy practice. This was followed by a series of seven articles on rational medicine use, published in leading local English news daily. The participants were reminded to read them on the day of publication of each article. As a backup, the articles were displayed on the notice board of respective colleges. Second intervention was a half day interactive session where series of six lectures were delivered to the participants on the right and wrong approaches in pharmacy practice. Posters about the do's and dont's of rational pharmacy practice were also displayed at the venue. The session was followed by a repeat test using the same pre-test to assess the change. Pre and post intervention data was compared using Fisher's Exact test. RESULTS: It was observed that the intervention did bring about a positive change in the attitude and knowledge of the final year Pharmacy students about rational pharmacy practice. DISCUSSION: The role of a pharmacist in health care provision is usually overlooked in India. Hence there is strong need for reinforcement in final year B. Pharm when most of the students go in for community service. Such interventions will be helpful in bringing about a positive change towards rational practice of pharmacy. CONCLUSION: This study showed that a properly timed and meticulously implemented intervention brings about a positive change in the attitude and knowledge of pharmacy students.