Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




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Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

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Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : March | Volume : 16 | Issue : 3 | Page : AC05 - AC09 Full Version

Behaviour of Students of Senior Secondary School towards Caffeine in Western Uttar Pradesh, India


Published: March 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/53370.16098
Ishi jain , Alok Tripathi , Ravi Pratap Singh

1. Tutor, Department of Anatomy, Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India. 2. Associate Professor, Department of Anatomy, Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India. 3. Assistant Professor, Department of Biochemistry, Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India.

Correspondence Address :
Dr. Ishi Jain,
Tutor, Department of Anatomy, Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India.
E-mail: jain.ishi17@gmail.com

Abstract

Introduction: On entering 11th and 12th standard students feels a load of studies and lack of energy to combat that, an increase in caffeine consumption is observed in students which have both short and long term side-effects.

Aim: This study has been undertaken to throw light on the unspoken side of the coin called caffeine consumption by students of senior secondary school to relieve stress.

Materials and Methods: This was an observational study done over a period of six weeks from 1st September to 15th October 2021. Data was collected from senior secondary schools of western Uttar Pradesh, India, via semistructured questionnaire which was followed by the audio-visual presentation about caffeine. After one week of presentation same questionnaire was distributed and change was evaluated and compiled in form of adequate tables to study the responses. Data were entered in an MS Excel and tabulated in form of tables.

Results: Out of 1000 students, 920 (92%) students knew caffeine, among whom 500 (50%) students knew the side-effects of caffeine. A total of 780 (78%) students had a perception that caffeine is addictive. Among the reasons for caffeine consumption, to ward away sleep (51%) was the most prominent. Coffee was the most consumed caffeinated product (61%).

Conclusion: From the present study, it be concluded that there is a lack of knowledge in students about caffeine intake and its side-effects which can affect their health.

Keywords

11th and 12th standard, Coffee, Harmful effect, Health

When students enter the 11th standard there is a lot of pressure on them regarding their careers. Regardless of the stream they chose, they are just concerned about the upcoming competitive exams and their board exams. They need to attend long coaching hours after school and late-night studies leading to a very hectic lifestyle to overcome their energy deficiency they start consuming a lot of caffeine unaware of the harmful effects and dangerous signs. Caffeine is a pharmacologically active substance which is both used and abused worldwide. It is present in many different products such as tea, coffee, soft drink, and energy drinks. Caffeine consumption is popular among people because of its unique ability to enhance mood and alertness, increase exercise capacity, to increase wakefulness and mental alertness (1). Students are not even aware that some of the products they are consuming contain caffeine. One major question is what actually is caffeine? Sixty plant species produce caffeine as xanthine alkaloid. Cocoa beans, kola nuts, tea leaves, and coffee beans are most famous ones. Some other example of these species is Yerba mate and gharana berries (2).

Apart from coffee and tea, dark chocolates, soft drinks, soda, milk chocolate, energy drinks, energy bars, green tea, weight loss pills, etc., also contain a considerable amount of caffeine (2). Consumption of these products without knowing about the amount of caffeine in these products can lead to side-effects. The side-effects mentioned in Diagnostic and Statical Manual of Mental Disorder (DSM-5) includes nervousness, insomnia, restlessness, excitement, diuresis, gastrointestinal disturbance, jitters, psychomotor agitation and tachycardia (3). During childhood and adolescence, the brain undergoes intensive development, especially those centres which are responsible for the performance, planning and emotional control, where frequent caffeine consumption by these groups may have adverse health impacts. When consumed in adequate amount (20-200 mg/day) caffeine produces favourable effects like alertness, increase in energy, low fatiguability, improvement in behavioural and cognitive function but if consumed at a higher dose (>200 mg/day) it can cause undesired effects like anxiety, gastrointestinal disturbances, jitters, tremors, tachycardia and psychomotor agitation (4). The over and influential advertising of these caffeinated products and their easy accessibility in market has made them acceptable and readily available for all age groups in a population. Caffeine can also show synergistic effects with other substances and reinforce as unhealthy behaviour for example caffeine in sugar drinks can lead to obesity and other lifestyle-related disorders, caffeine show neurobiological effects which stimulates the relaxing effect of nicotine leading to increase consumption of both caffeine and tobacco. Food and Drug Administration (FDA) classify caffeine as generally safe and according to them, the toxic dose is >10 g/day
for an adult (5). Pure powder form of caffeine is also available in market as a dietary supplement which is life threatening even in a table spoon amount (5). Caffeine has ability to produce physiological effects which are produced by any drug of dependence, it also shows potential of tolerance, withdrawal and dependence so all these points makes caffeine to fit into the criteria of addictive substances. Therefore, everyone should be careful and aware of what they are consuming.

The study was conducted to evaluate the knowledge and behaviour of students of 11th and 12th standards of Indian schools regarding the consumption of caffeinated products. This knowledge is important for both short and long-term health-related effects. Students should be aware that what they are consuming contains what and how can it affect their health.

Material and Methods

The present study was an observational study, conducted over a period of six weeks from 1st September to 15th October 2021. Before starting the study approval from the Institutional Ethical Committee (IEC) (ECA{EWINST/202111540}) of Subharti Medical College (SMC), Meerut, India, in accordance with the Helsinki Declaration of 1975, revised in 2000 was taken.

The study was conducted in senior secondary schools of western Uttar Pradesh, India, which were selected purposively because of the presence of an easily accessible school canteen that provides caffeinated products. Also, as per general observation, most of the students belong to upper socio-economic classes which increase the probability of their caffeine consumption. For conducting the study on 1000 students of the 11th and 12th standard, a semi-structured questionnaire [Questionnaire] was used. The sample size was calculated using a 4PQ/L2.

Inclusion criteria: Students of 11th and 12th class of western Uttar Pradesh, India and willing to participate were included in this study.

Exclusion criteria: Students below 11th class and unwilling to participate were excluded in this study.

Study Procedure

After taking informed consent from the participating students information was gathered on a semi-structured questionnaire by distributing them amongst the students assembled in the school library. Through the questionnaire, knowledge was gained on their current knowledge and behaviour regarding the consumption of caffeinated products. It was followed by an audio-visual presentation about the side-effects, safe limit, addiction, health hazards of caffeine along with a list of non caffeinated products. Then after one week, the schools was visited again and the same questionnaire was distributed to the same students. The motive of the second round of questionnaires was to see the percentage change in their knowledge about caffeine.

Statistical Analysis

Data were entered in an MS Excel Sheet and tabulated in form of tables.

Results

In (Table/Fig 1) socio-demographic characteristics of the study population is shown. A 21% of students were of 15 years of age, 57% were 16 years, and 22% were 17 years age. Amongst the students, 72% students were boys and 28% students were girls. Father of 47% students was professional, 33% were semi-professional, 16% were cleric/shop-owner/farmer and 4% were skilled worker by occupation. Socio-economic class according to modified Kuppuswamy socio-economic classification 2017 (6), 46% of students belonged to the upper class and 54% belonged to the upper-middle class. A total of 17% students were of commerce and 83% students were of science stream. A 22% of students were in 11th standard and 78% students were in 12th standard.

The (Table/Fig 2) shows the association between students who knew about caffeine before and after the audio-visual presentation. There was an increase of 8% in the knowledge of students regarding caffeine after the presentation.

The (Table/Fig 3) shows the association between students’ knowledge about individual side-effects of caffeine before and after the audio-visual presentation. About 780 (78%) students had a perception that caffeine is addictive. There was an increase of 13% in the knowledge of addiction, a decrease of 4% in the knowledge of caffeine being carcinogenic, and an increase of 8% in the knowledge of caffeine affecting Central Nervous System (CNS), after the presentation.

The (Table/Fig 4) shows the association between the knowledge of students about products containing caffeine before and after the audio-visual presentation. There was an increase of 26% in the knowledge of students regarding products containing caffeine after the presentation.

The (Table/Fig 5) shows the distribution of students of the study group according to caffeine consumption. Amongst the students, 51% said that they consume caffeine to ward away sleep, 24% for enhancing taste, 23% for increasing concentration, 13% for driving long distances, 12% to cure headaches, and 4% to decrease the effect of alcohol and before the workout.

The (Table/Fig 6) shows the distribution of students according to most common problems faced by students after consuming caffeine. After consuming caffeine 20% experience racing thoughts, 15% gastrointestinal disturbance 10% insomnia, 8% nervousness, and 6% jitters.

Discussion

In present study group, it was observed that 21% of the participating students were of 15 years of age, 57% were of 16 years of age, 22% were 17 years of age, similarly Gera M et al., showed that majority of age group was 21% in 15 years of age (7). In the present study, there was a male preponderance with 72% and 28% of female students while in the study by Ahmad M et al., male to female number was a bit higher with 75% males and 45% were females (8). In present study, conducted on school students of 11th and 12th standard where 17% were from commerce stream and 83% were from science stream while Ahmad M et al., in their study found that the ratio was equal in both the streams i.e., 50% from science and 50% from commerce which was inconsistent with the results of present study (8).

In the present study, it was observed that among all the students 51% students consumed caffeine to ward away sleep, 23% to increase concentration, 4% to decrease the effect of alcohol and boost workout, 24% to enhance taste, 13% for aiding to drive long distances, 12% to cure headache, 23% did not have any reason. While Ahmad M et al., in their study found that 38.7% of students consumed caffeine to ward off sleep which was lower than present study, 33% used caffeine to increase concentration which was higher as compared to present study and 7.9% said that caffeine helped in memorising their subjects (8). In present study, common problems faced by students were- GI disturbances, insomnia, nervousness, jitters, racing thoughts whereas Evans MS et al., in their study found that the common problems after consuming caffeine were feeling of anxiety, nausea, jitteriness, nervousness, restlessness, insomnia, GI disturbances, tremors, tachycardia (9).

Limitation(s)

This study only includes students of senior secondary school. Only change in knowledge about caffeine was evaluated after an audio-visual presentation.

Conclusion

From this study, it can be concluded that students are lacking in knowledge about caffeine and caffeinated products. Due to which there is irrational consumption of caffeinated products. Caffeine is the new alcohol of youngsters as there is no as such ‘restriction on consuming it and it is slowly becoming a part of student’s lifestyle with its harmful effects. So, students need to realise that they should be aware of what they are consuming. Students should learn how to limit their caffeine intake otherwise they have to face health issues. Proper consoling is necessary for parents, students and teachers.

References

1.
Shree Lakshmi Devi S, Abilash SC, Basalingappa S. The rationale of caffeine consumption and its symptoms during preparatory & non-preparatory days: A study among medical students. Biomedical & Pharmacology Journal. 2018;11(2)1153-59. [crossref]
2.
Md Sahab U, Sufian MA, Md. Hossain F, Md. Kabir T, Islam T, Md. Rahman M, et al. Neuropsychological effects of caffeine: Is caffeine addictive. Journal of Psychology & Psychotherapy. 2017;7(2)12.
3.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th edition. 2021.
4.
Edward HD, Laura JM. Caffeine Expectancy Questionnaire (Caff EQ): Construction, psychometric properties, and associations with caffeine use, caffeine dependence, and other related variables. American Psychological Association. 2012;24(3)592-60. [crossref] [PubMed]
5.
Priadarsini T, Gayatridevi R. Caffeine consumption habits and perception of adolescents in Chennai Population. Asian Journal of Pharmaceutical and Clinical Research. 2016;9(Suppl. 3)149-51. [crossref]
6.
K. Park. Textbook of Preventive and Social Medicine, 25th edition, Bhanot, 2019, chap-12, pp-746.
7.
Gera M, Kalra S, Gupta P. Caffeine intake among adolescents in Delhi. Indian Journal of Community Medicine. 2016;41(2)151. [crossref] [PubMed]
8.
Ahmad M, Hinna ER, Tayyab A. Knowledge and trends of caffeine consumption among medical and nonmedical students of Lahore, Pakistan. Pakistan Journal Neurological Sciences. 2017;12(2) 24-30.
9.
Evans MS, Griffiths RR. Caffeine withdrawal: A parametric analysis of caffeine dosing conditions. The Journal of Pharmacology and Experimental Therapeutics. 1999;289(1)285-94.

DOI and Others

DOI: 10.7860/JCDR/2022/53370.16098

Date of Submission: Nov 20, 2021
Date of Peer Review: Dec 18, 2021
Date of Acceptance: Jan 13, 2022
Date of Publishing: Mar 01, 2022

AUTHOR DECLARATATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
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• iThenticate Software: Jan 14, 2022 (4%)

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