Analgesics Self-Medication and its Association with Sleep Quality among Medical Undergraduates

Patterns in behavioural sleep variables and social jetlag in elderly people of Western Odisha

In humans, sleep is an essential physiological process for life and survival. The main objective of the current study is to determine the behavioural sleep patterns and social jetlag in elderly adults. The second objective is to define the relationship among subjective sleep quality, mid-sleep timings, social jetlag, and sunlight exposure. We recruited 945 female and 1047 male participants aged ≥ 60 years from 65 rural villages in the Sambalpur district of Odisha, India. The Munich Chrono Type Questionnaire (MCTQ) is a self-reported questionnaire that measures a person's behavioral sleep variables, including social jetlag and chronotype, whereas the Pittsburgh Sleep Quality Index (PSQI) measures the subjective sleep quality of an individual. We employed MCTQ and PSQI to obtain behavioral sleep variables and subjective sleep quality in the recruited subjects. The behavioral sleep variables were compared using a paired t-test on both work and work-free days. In addition, the behavioral sleep variables as a function of gender were compared using an independent Student's t-test. In the current study, most of the elderly individuals reported both midpoint of sleep on workdays (MSW) and midpoint of sleep on work-free days (MSF) between 00:01-03:00. The averages of mid-sleep timings between workdays and work-free days were not statistically significant. Data on MSFsc (midpoint of sleep on work-free days sleep corrected) indicated that most elderly adults (99.6%) are morning type; they go to bed early and wake up early. The elderly participants from the rural population of Sambalpur district in western Odisha had the least social jetlag and exhibited good subjective sleep quality. It would be worthwhile to find out the determinants of these positive features apropos social jetlag and behavioural sleep patterns.

The Worldwide Prevalence of Sleep Problems Among Medical Students by Problem, Country, and COVID-19 Status: a Systematic Review, Meta-analysis, and Meta-regression of 109 Studies Involving 59427 Participants

Abstract

Purpose of Review

Several studies have found that medical students have a significant prevalence of sleep issues, such as poor sleep quality, excessive daytime sleepiness, and inadequate sleep duration. The purpose of this review is to carefully evaluate the current research on sleep problems among medical students and, as a result, estimate the prevalence of these disturbances. The EMBASE, PsychINFO, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science and retrieved article reference lists were rigorously searched and rated for quality. Random effects meta-analysis was performed to compute estimates.

Recent Findings

The current meta-analysis revealed an alarming estimated pooled prevalence of poor sleep quality (K = 95, N = 54894) of 55.64% [95%CI 51.45%; 59.74%]. A total of 33.32% [95%CI 26.52%; 40.91%] of the students (K = 28, N = 10122) experienced excessive sleepiness during the day. The average sleep duration for medical students (K = 35, N = 18052) is only 6.5 h per night [95%CI 6.24; 6.64], which suggests that at least 30% of them get less sleep than the recommended 7-9 h per night.

Summary

Sleep issues are common among medical students, making them a genuine problem. Future research should focus on prevention and intervention initiatives aimed at these groups.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40675-023-00258-5.

Prevalence and Predictors of Self-Medication Practices in India: A Systematic Literature Review and Meta-Analysis

BACKGROUND

Self-Medication (SM) is a practice of using medications to treat selfdiagnosed symptoms without a legitimate prescription by a health care professional. Alongside posing a burden on a patient, SM practices are associated with certain unfavourable health conditions such as drug-resistance, adverse effects, drug-interactions, including death.

OBJECTIVE

To systematically review and quantify the prevalence of SM practices and its associated factors in India.

METHODS

A comprehensive systematic search was performed using scientific databases such as PubMed and Cochrane library for the peer-reviewed research articles that were conducted in India without any language and date restrictions. Studies which were cross-sectional by design and assessing the prevalence and predictors of SM practices in India were considered for the review, and all the relevant articles were screened for their eligibility.

RESULTS

Of 248 articles, a total of 17 articles comprising of 10,248 participants were included in the meta-analysis. Overall, the mean prevalence of SM practices in India was observed to be 53.57%. Familiarity with the medication appears to be a major reason to practice SM (PR: 30.45; 95% Confidence Interval [CI]: 17.08-43.82; 6 studies), and the practice was noticed more among individuals from a middle-lower class family with a prevalence rate of 26.31 (95%CI: 2.02-50.60; P<0.0001). Minor ailments were the primary reason for practicing SM (PR: 42.46; 95%CI: 21.87- 63.06), among which headache was the most commonly reported (PR: 41.53; 95%CI: 18.05-65.02).

CONCLUSION

Self-medication practices are quite frequent in India. While NSAIDs and anti-allergens are the most frequently utilized self-medicated drugs used for headache and cold and cough.

Prevalence of insomnia among university students in South Asian Region: a systematic review of studies

INTRODUCTION

Insomnia is a global health problem among university students which is associated with various psychiatric problems like depression and anxiety. While different developed and developing countries assessed the prevalence of insomnia in youth, currently there is hardly systematic review of studies found based on the prevalence of insomnia in South Asia.

AIMS

The aim of this study is to systematically review the evidence relating to the prevalence rate of insomnia in university students in South Asian countries.

METHODS

Electronic searches of three databases, PubMed, Cochrane library, and Worldwide science were performed from 2010 to 2020 before April. In total, seven studies were included for evaluating insomnia in South Asian region among university students.

RESULTS

The prevalence rates of insomnia of the seven studies ranged between 35.4% (95% CI: 32.4-38.5%) and 70% (95% CI: 65.7-74.1%). The pooled prevalence of insomnia among university students was 52.1% (95% CI: 41.1-63.1%).

CONCLUSIONS

This review emphasized that insomnia in university students might be a common health issue to give full concentration in their studies and academic performance. Thus, more attention should be given to the determinants of insomnia among university students, so that it could be helpful to identify the main causes of insomnia and effective measures could be taken.

Sleep quality in medical students: a comprehensive meta-analysis of observational studies

PURPOSE

Poor sleep quality is common in medical students and is associated with a number of negative health outcomes. However, the prevalence estimates of poor sleep quality in medical students vary widely across studies. We thus conducted a meta-analysis of the prevalence of poor sleep quality and its mediating factors in medical students.

METHODS

A systematic literature search of PubMed, EMBASE, Web of Science, PsycINFO, and Medline Complete was performed. The random-effects model was used to analyze the pooled prevalence of poor sleep quality and its 95% confidence intervals (CIs).

RESULTS

A total of 57 studies with 25,735 medical students were included. The pooled prevalence of poor sleep quality was 52.7% (95% CI: 45.3% to 60.1%) using the Pittsburgh Sleep Quality Index (PSQI). The pooled mean total PSQI score across 41 studies with available data was 6.1 (95% CI: 5.6 to 6.5). Subgroup analyses found that PSQI cutoff value and study region were associated with the prevalence of poor sleep quality (P = 0.0003 VS. P = 0.005). Across the continents, poor sleep quality was most common in Europe, followed by the Americas, Africa, Asia, and Oceania. Meta-regression analyses found that smaller sample size (slope = - 0.0001, P = 0.009) was significantly associated with higher prevalence of poor sleep quality.

CONCLUSIONS

Poor sleep quality is common among medical students, especially in Europe and the Americas continets. Due to the negative health outcomes, regular screening of poor sleep quality and effective interventions are needed for medical students.

Assessment of knowledge, attitude, and practice toward responsible self-medication among students of pharmacy colleges located in Anantapur district, Andhra Pradesh, India

INTRODUCTION

Responsible self-medication plays a vital role in appropriate use of nonprescription drugs which will improve safety and reduces unwanted effects of drugs.

AIM

This study is designed to assess knowledge, attitude, and practice (KAP) toward responsible self-medication among pharmacy students.

SETTINGS AND DESIGN

A cross-sectional survey was conducted in pharmacy students of various colleges located in Anantapur district, Andhra Pradesh, India.

MATERIALS AND METHODS

A total of 403 pharmacy students were enrolled and subjected for interview using prevalidated KAP questionnaire on responsible self-medication.

STATISTICAL ANALYSIS

Descriptive statistics were used to represent the sociodemographic characteristics and KAP levels. Association of socio-demographic variables with KAP levels are determined using the Chi-square test.

RESULTS AND DISCUSSION

A total of 403 pharmacy students are recruited in the study, in these 19 (4.7%) diploma in pharmacy, 260 (64.5%) bachelor in pharmacy, 27 (6.7%) master in pharmacy, and 97 (24.1%) are doctor of pharmacy. Among 403 respondents, 150 (37.2%) good knowledge, 397 (98.5%) positive attitude, and 170 (42.2%) practice toward responsible self-medication. Respondent's age, pharmacy division, residence, and their parents' profession were significantly associated with good knowledge and rational practice toward responsible self-medication with a P < 0.05.

CONCLUSION

The study concludes that pharmacy students are shown more positive attitude toward responsible self-medication. However, students are lack of knowledge and practice of responsible self-medication.