Background: Antibiotics, one of the frequently prescribed medications in modern medicine is plagued by misuse and consequent development of resistance. We report the knowledge and practice of antibiotic use and the extent of self-medication with antibiotics among health science students of a university in south India. Methods: A cross-sectional study was carried out that included students from various disciplines such as Medicine, Dentistry, Pharmacy, and Nursing. A random sample of 531 students, were recruited into the study and those students with a history of any chronic disease requiring long-term treatment were excluded. Results: Almost 58% reported using antibiotics in the last 3 months and 39% frequented its use over 3 times in a year. Thirty percent stated that they had procured antibiotics over the counter without a valid prescription. Common ailments that reportedly triggered antibiotic use, ranged from mild fever to skin infections. Medical (25%) & Dental (36%) students declared self-prescription as a frequent practice. b-lactam group was the most popular group of antibiotics, with over 44% vouching its use. Conclusion: There appears to be inadequate adherence to antibiotic policies among the study population warranting periodic training and monitoring. Establishment of an effective antibiotic stewardship could be the way forward.

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A 20-year-old nulliparous woman, married since one year, presented to the outpatient department with complaints of three months of amenorrhea followed by increased bleeding per vagina, hyperemesis and abdominal pain of one week duration. She also complained of tremors and palpitation. There was no history of abdominal distension or diarrhoea. There was no history of menstrual irregularity prior to the current episode.On examination, her pulse rate was 110 beats per minute and regular in rhythm, blood pressure was 120/78 mmHg, respiratory rate was 16 breaths per minute and oxygen saturation was 99% at room air. She was found to have conjunctival pallor and diffuse non tender enlargement of the thyroid gland. On abdominal examination, there was no palpable mass present. On per vaginal examination, the uterus was found to be bulky (about 10 weeks of gestational size), anteverted, with mild cervical motion tenderness present. Bilateral fornices were free and non tender. Urine pregnancy test was found to be positive. Transvaginal ultrasound of pelvis revealed uterus which measured 10.6x7 cm, with intrauterine gestational sac measuring 4.3 cm and presence of anechoic areas likely to be cystic, suggestive of molar pregnancy. Bilateral ovaries on ultrasound showed theca lutein cysts with the largest measuring 18 mm. Laboratory data showed β-hCG levels of 8,04,578 mIU/ ml, haemoglobin of 8.4 g/dl, peripheral smear showed microcytic hypochromic picture, TSH levels of 0.015 mIU/ml, T3 of 3.07 ng/ ml and T4 of 24.86 μg/dl. Thyroid profile was done after seeking consultation with physician for tremors and palpitation. Ultrasound of the thyroid gland showed diffuse enlargement of the gland without nodularity and Technetium-99m scan of thyroid was done which was found to be normal. Electrocardiogram showed sinus tachycardia and 2D-ECHO was normal.She was subsequently admitted and transfused 2 units of packed red blood cells and was started on propranolol (60 mg/day). An ultrasound guided suction evacuation of products of conception was done under general anaesthesia three days following admission. Histopathology report of specimen confirmed diagnosis of hydatidiform mole [Table/ Fig-1]. A repeat ultrasound scan done following evacuation showed retained products of conception and laboratory data showed β-hCG of 89,677 mIU/ml, TSH of 0. AbSTRACTMolar pregnancy is one of the components of a broader spectrum of diseases known as Gestational Trophoblastic Disease (GTD), presenting with amenorrhoea and irregular bleeding which may be rarely associated with passage of vesicles per vagina. However, it can rarely be associated with hyperthyroidism, which may be associated with clinical features of hyperthyroidism. The following is a report of a 20-year-old woman who presented with amenorrhea followed by irregular bleeding per vagina, thyromegaly and abnormal levels of thyroid hormones. Transvaginal ultrasound revealed features consistent with molar pregnancy. A suction evacuation was done following which serum levels of β-hCG reduced ...