Vol 13, Issue 2, Apr-Jun, 2023

Background: Any health system should focus on three key aspects of medicines-accessibility, affordability, and rational use of medicine. Rational use of medicines (RUM) requires that “patients receive medicines that meet their clinical needs, at doses that meet their individual needs, over an appropriate period of time, and at the lowest cost to both patients and their communities. Aim: This study was conducted to assess the knowledge, attitude and practice on RUM among medical students. Materials and Methods : This was a survey-based cross-sectional study conducted after approval by the institutional ethics committee. The study population included 187 second year MBBS (fourth semester) students of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, U.P, India. They were informed about the study and their consent was obtained. The identity of the students was not disclosed. Results: Total 187 students participated in the study, 103 males and 84 females. Most of them believe that it is not safe to take prescribed medicines with over the counter (OTC) medicines (55.08%). The majority of respondents (73.26%) believed that the pharmaceutical industry benefits most from irrational prescriptions, while only 6.95% believed that mass communication is a poor medium to educate people about medicines. 63.64% believed that dietary supplements can be taken without a prescription, and 55.08% believed that they read the package insert at OTC. Conclusion: Medical students will be prescribing drugs in future, they need to be aware of all aspects of Rationale use of medicine. RUM is included in the undergraduate curriculum, education in this area must be proper and vigorous so that they can be groomed to become great future prescribers. Keywords: Rational Use of Medicine, Over-the-Counter, generic, Medical Students, Knowledge, Attitude and Practice.

Background: In 2011, in an effort to increase focus on newborn care and survival, the Ministry of Health and Family Welfare, Government of India, formally introduced the three-tier Facility Based Newborn Care (FBNC) system at various levels of health facilities. This study evaluates the functional status of newborn care facilities in a northern state of India. Materials and Methods: A cross sectional, mixed methods, descriptive study was conducted during the months of May to July 2021. Six districts were selected for the study representing each of the six administrative divisions of the state. A total of 31 facility based newborn care units were assessed, including six Special Newborn Care Units (SNCU), six Newborn Stabilization Units (NBSU) and 19 Newborn Care Corners (NBCC). Human resources availability and training, infrastructure, equipment and supplies, adherence to standard operating procedures, infection control protocols and regular maintenance of records were assessed. Overall functional status was ascertained using five criteria: Equipment, Human resources, Protocol, Infrastructure and Recordkeeping. Results: Though the prescribed strength of manpower was available at almost all facilities, most reported that they had not received specific on-the-job training on newborn care. Infrastructure and biomedical waste disposal facility was found to be adequate at all levels. However, the complete set of prescribed essential neonatal care equipment was not available and functional in any of the NBSUs and in a very small number of SNCUs and NBCCs. Most of the SNCUs and NBCCs were found to be partially functional according to the set criteria. Conclusion: Adequate functionality of NBSUs needs to be ensured in order to maximize the benefits of the three-tier system of FBNC. Keywords: Facility based newborn care, Newborn care units, Health systems framework, Assessment, Neonatal mortality.

Background: COVID-19 has been shown to cause an overactivation of monocytes. The Monocyte Distribution Width (MDW) parameter correlates with the cytomorphological changes that monocytes undergo after their massive activation. MDW is obtained from the blood count, and it could be established as a potential diagnostic biomarker for COVID-19. Therefore, the aim of this study is to deeply analyze the value of MDW in patients with SARS-CoV-2 infection. Materials and Methods: A total of 4,153 patients treated in the Emergency Department with suspicion of SARS-CoV-2 infection due to suggestive symptoms were recruited. A blood count and a nasopharyngeal swab for SARS-CoV-2 RNA detection were requested. Results: Significant differences (p<0.001) were observed between the MDW values in patients with COVID-19 (n =1285), with a mean and standard deviation of 23.69 ± 4.27 compared to patients without COVID-19 disease (n = 2870) whose mean and standard deviation is 19.17 ± 3.52. The Area Under the Curve (AUC) obtained was 0.822 and the cut-off point was MDW≥20.8, (77.7% sensitivity, 78.1% specificity). The combination of MDW with White Blood Count (WBC) through a regression model got the best AUC (AUC=0.855), with a sensitivity of 79.2% and a specificity of 83.7%. Conclusion: Patients with SARS-CoV-2 infection have been shown to have higher MDW values. The combination of MDW with WBC allowed to obtain the highest specificity from all the studies performed, so this combination could be helpful when classifying patients with possible COVID-19. Both markers are obtained very quickly and easily from a blood count sample. Keywords: MDW, COVID-19, White blood cell, Diagnostic, Pandemic, Laboratory.

Introduction: All over the world Alcohol Dependence Syndrome (ADS) is most significant health problem. Among different individuals, the severity of liver dysfunction related to alcohol varies and related to different factors including personality traits. Aim: To find the personality variables of alcohol dependent patients and to determine its association with liver enzymes level among them. Materials and Methods: Total of 100 patients were selected from psychiatry department of JNMC, Sawangi, Wardha, Maharashtra and they were assessed through socio-demographic proforma, 16 personality factor (16 PF) inventory and liver function tests. Results: Most of the participants scored high on factors warmth (56%), social boldness (56%), dominance (67%), vigilance (77%), sensitivity (70%), perfectionism (52%) and openness to change (65%); while comparatively scored lower on factors privateness (50%) and liveliness (35%). The personality factors emotional stability, dominance, sensitivity, abstractedness, apprehension, self-reliance, perfectionism and tension were significantly correlated with various liver enzymes; whereas, global factor Extraversion/Introversion, Tough-mindedeness/Receptivity and Independence/ Accommodation were correlated with various liver enzymes when p < 0.05 considered significant. Conclusion: This study suggests that the personality factors affect the liver enzymes level in alcohol dependent subjects. Hence, the personality factors should be addressed by physician during intervention to improve outcome. Keywords: Personality traits, Alcoholism, Liver enzymes level, Alcohol dependence.

Purpose: The purpose of the paper "Bibliometric Analysis of ChatGPT's Applications in Medicine: A Comprehensive Assessment of its Impact and Potential" is to conduct a systematic evaluation of how ChatGPT, an AI language model, has been applied in the field of medicine. The study aims to assess the impact of ChatGPT's applications in medicine and explore its potential contributions to the healthcare domain. Materials and Methods: The Scopus database was selected and the search query (All (ChatGPT AND Medicine) was developed on 11, July 2023 to retrieve all the bibliographic records on the domine of interest. From each record, we retrieved data on the title, author, organizations, journals, publications type, source, country, collaboration, etc. They were exported to MS-Excel for bibliometric analysis and VOSviewer software was used for analyzing Co-Occurrence networks and the data and descriptive analysis were classified, collected one by one, and loaded into the Bibliometric R-package program to create science maps and statistical graphs. Results: ChatGPT - related Medicine papers in the Scopus database constitute 532 papers. these publications received 1046 citations, these authored by 1771 authors published 203 article type and etc. Average citations per document 1966 received and 111 (20.86%) received extremal funding support from 62+ research agencies supporting research in this area. selected 65 significant keywords appearing in ChatGPT and Medicine. USA and UK were contributed the highest papers. Medicine is the broad subject of the study were published highest number of papers (312). Conclusion: The findings from this study can help researchers, practitioners, and policymakers better understand the impact and potential of ChatGPT in advancing medical knowledge, patient care, and healthcare practices. Additionally, the paper may contribute to identifying knowledge gaps and guide further research in this rapidly evolving field at the intersection of AI and medicine. Keywords: Bibliometric, ChatGPT, Medicine, Impact, Scopus database.

Mental health stigma continues to be a significant barrier to seeking help and support for individuals experiencing psychological distress. Despite growing awareness of mental health issues, many people still face discrimination and prejudice due to societal misconceptions surrounding mental health conditions. However, in recent years, social media platforms have emerged as powerful tools that can potentially challenge and dismantle mental health stigma. This article aims to explore the role of social media in addressing mental health stigma, highlighting its impact, challenges, and opportunities. Through the analysis of relevant studies and initiatives, we aim to understand how social media can play a pivotal role in promoting mental health awareness and fostering an inclusive and empathetic online community.

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is the most prevalent chronic liver disease globally, ranging from simple steatosis to Non-Alcoholic Steatohepatitis (NASH) and cirrhosis. It is closely linked to rising rates of obesity and diabetes. This study aims to evaluate the clinical profile of NAFLD patients attending the outpatient department at Nalanda Medical College & Hospital (NMCH), Patna. Materials and Methods: A cross-sectional, observational, clinico-demographic study was conducted on 112 patients diagnosed with NAFLD via ultrasonography at NMCH, Patna. Participants were selected based on predefined inclusion and exclusion criteria. Detailed histories and investigative reports were collected and analyzed to assess demographic characteristics, laboratory parameters, liver enzymes, comorbid conditions, lipid profiles, and metabolic indicators. Results: The age distribution highlighted that NAFLD primarily affects middle-aged and older adults, with the highest prevalence in the 50-59 age group (26.78%). Males comprised 53.57% of the patient population. Hepatomegaly was observed in 24.10% of patients. Laboratory analyses revealed elevated SGPT (ALT) in 21.42% and SGOT (AST) in 16.96% of cases. The ALT/AST ratio of ≥1 was found in 41.96% of patients. Comorbid conditions, primarily diabetes (34.82%) and hypertension (30.35%), were present in 68.75% of patients. Elevated lipid levels were common, with high triglycerides (41.96%) and low HDL levels in both males (56.66%) and females (73.07%). The prevalence of overweight (45.53%) and obesity (30.35%) was notable, with a significant portion exhibiting central adiposity. Conclusion: NAFLD predominantly affects obese, middle-aged patients with diabetes and hypertension, often presenting with modest liver enzyme elevations and normal bilirubin levels. Comprehensive management strategies are crucial to preventing progression to cirrhosis. Further multicenter studies are required to deepen the understanding of NAFLD's risk factors and clinical profile, facilitating effective intervention strategies. Keywords: Non-Alcoholic Fatty Liver Disease (NAFLD), Non-Alcoholic Steatohepatitis (NASH), Diabetes, Hypertension, Liver Enzymes, Comorbidities, Obesity, Lipid Profile.