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

Users Online : 18364

AbstractMaterial and MethodsResultsDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



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




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



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




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
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.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



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 : 2023 | Month : January | Volume : 17 | Issue : 1 | Page : NC05 - NC09 Full Version

Knowledge and Attitude about Eye Donation among First and Second versus Final Year MBBS Students: A Cross-sectional Study


Published: January 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/59438.17334
Sumit Goyal, Neha K Sethi, Charu Chadha, Gagandeep Kaur, Urvashi Grover, Anchal Garg

1. Senior Resident, Department of Ophthalmology, GGS Medical College, Faridkot, Punjab, India. 2. Assistant Professor, Department of Ophthalmology, GGS Medical College, Faridkot, Punjab, India. 3. Senior Resident, Department of Ophthalmology, GGS Medical College, Faridkot, Punjab, India. 4. Assistant Professor, Department of Ophthalmology, GGS Medical College, Faridkot, Punjab, India. 5. Assistant Professor, Department of Community Medicine, GGS Medical College, Faridkot, Punjab, India. 6. Junior Resident, Department of Anaesthesia, GGS Medical College, Faridkot, Punjab, India.

Correspondence Address :
Dr. Neha K Sethi,
Assistant Professor, Department of Ophthalmology, GGS Medical College, Faridkot, Punjab, India.
E-mail: neha.knew@gmail.com

Abstract

Introduction: The cure of corneal blindness requires manifold increase in the rate of eye donation. The present study was undertaken to assess the knowledge and attitude about eye donation among medical students. A secondary objective of the study was to assess the impact of knowledge of eye donation after studying ophthalmology among the final year students of the MBBS (Bachelor of Medicine Bachelor of Surgery) graduation course.

Aim: To assess knowledge and attitude about eye donation among first, second and final year medical students. Also, to assess the impact of studying ‘Ophthalmology’ on their knowledge.

Materials and Methods: A cross-sectional study was conducted by collecting information on a predesigned, structured questionnaire on ‘Google forms’ and sending a soft copy to 601 students of two medical colleges i.e, GGS Medical College, Faridkot and Dayanand Medical College, Ludhiana, Punjab, India, by email, from March 2019 to April 2019. There were questions about awareness and source of information about eye donation in medical students, knowledge of criteria, and willingness to donate eyes. Responses were accepted till a period of seven days. Students were divided into two groups; group A (n=320 students) with 165 students in first professional year and 155 in second professional year, who had not studied Ophthalmology. Group B (n=281 students) with 142 students in final (part I) professional year and 155 in final (part II) professional year, who had/were studying Ophthalmology. Results were analysed and compared using Chi-square test.

Results: Out of 601 students, 527 responded (272 of group A and 255 of group B). The results on knowledge and willingness to donate eyes were quite encouraging. Most of the questions were answered by more than 400 students. Majority of students cited teachers/friends as their source of knowledge. However, there was a saw significant gaps in knowledge in the students, specially before reading Ophthalmology (p-value<0.05).

Conclusion: More efforts in the form of counselling techniques, short trainings, videos, need to be put into medical curriculum, ophthalmology teaching and short in-job trainings to make the MBBS students an important link in increasing cornea retrieval.

Keywords

Blindness, Cornea transplantation, Education, eye banks, MBBS curriculum

A large proportion of the huge burden of blindness in India is avoidable (1). Global prevalence of blindness was 3.38% in 2015 (2). According to the National Blindness and Visually Impaired Survey, the major cause of blindness in the population aged 0-49 years was corneal opacity contributing 37.5% (3). Urgent preventive and therapeutic measures are needed to decrease this increasing burden. It has been reported that nearly 90% of the global cases of ocular trauma and corneal ulceration leading to corneal blindness occur in developing countries (4). It is treatable by keratoplasty in most cases. However, a major obstacle for a corneal transplant is a lack of awareness about eye donation and a negative attitude in the general population (5).

The current corneal procurement rate stands at 49,000 per year (6). It is estimated that 277,000 donor tissues are needed every year, and the shortage of transplantable tissue deserves much attention (6). Hospital Cornea Retrieval Program (HRCP) has proven to be an effective technique for eye donation (7). To further increase the procurement of corneas, medical professionals can enhance the eye donation rates by educating and motivating the relatives in case of a patient’s death. Hence, the present study was undertaken to assess the knowledge and attitude about eye donation among medical students of Punjab. In India, Ophthalmology subject is taught in ‘final (part I) professional year (phase 3)’ of MBBS course; and no study has yet assessed its impact on student knowledge on eye banking and donation. So, secondary objective of the study was to assess the impact of knowledge of eye donation after studying ophthalmology among the final year students of the MBBS (Bachelor of Medicine Bachelor of Surgery) graduation course.

Material and Methods

A cross-sectional study was conducted among medical students of two medical colleges i.e, GGS Medical College, Faridkot and Dayanand Medical College, Ludhiana, Punjab, India, from March 2019 to April 2019. This study was approved by Institutional Review Board and complied with by the Declaration of Helinski. All the required information was collected on the self-designed, structured questionnaire on ‘Google forms’ (attached as (Table/Fig 1), and as supplemental file) sent to students as email link to elicit responses. Responses were accepted till a period of seven days. The validity of the research tool was checked by an intramural pilot study (n=12) from passed out MBBS students.

Inclusion and Exclusion criteria: All first, second and final year students of GGS Medical College and Dayanand medical college were included in the study. Those students who did not respond within the seven days period were automatically excluded from the study.

Questionnaire

The questionnaire was divided into four parts

• True/false option questions,
• Multiple-choice questions,
• Yes/no option questions, and
• Personal information.

It consisted of 16 questions pertaining to finding the knowledge and source of information about eye donation in medical students, knowledge of criteria, and willingness to donate eyes.

Total 601 MBBS students studying in the two medical colleges were included and the questionnaire was emailed to them.

Group A (n=320): Students studying preclinical and paraclinical subjects who had not studied Ophthalmology.
First professional year n= 165
Second professional year n=155

Group B (n=281): Students after studying the subject.
Final-I professional year n=142
Final-II professional year n=155

With an implied consent, the students were directed to answer the questionnaire by themselves, without help from other information sources (individual/books/internet). Knowledge gap was defined as the gap between knowledge of medical students before and after studying ophthalmology. Data collected was nominal data thus no scoring system was used.

Statistical Analysis

The information attained from the students’ responses to the questions were analysed using the Chi-square test. The comparison was done between group A and group B and significant difference between their knowledge was labelled as ‘impact of studying Ophthalmology/knowledge gap between groups’. A p-values less than 0.05 were taken as statistically significant. All statistical calculations were done using Statistical Package for the Social Science version 21.0 (SPSS Inc., Chicago, IL,United States of America) statistical program for Microsoft Windows. Knowledge and attitude were assessed for difference between groups by calculating p-value using Chi-square test.

Results

The questionnaire was sent to 601 students (320 and 281 who had not and were studying/studied ‘Ophthalmology’ subject respectively) of two medical colleges. Out of them, 527 students participated and provided responses. Out of these, 272 in the first and second professional year who had not studied Ophthalmology were labeled as group A, and the remaining 255 in the final professional year who were studying/had studied Ophthalmology were labeled as group B. The study flow diagram is provided as (Table/Fig 2). The groups were uniform with regards parent institution and constituent number of students. The age of the students ranged from 18 to 24 years with a mean of 20.25±1.52 years. The demographic details are provided in (Table/Fig 3).

The answers provided by the medical students to ‘true/false questions are aggregated in (Table/Fig 4). In response to MCQ on ‘source of knowledge’ about eye donation, the responses are aggregated in (Table/Fig 5). Most common answer was from friends/ teachers. In answers to MCQ on ‘eligibility to donate’ are summarized in (Table/Fig 6). The answers to ‘yes/no style questions are aggregated in (Table/Fig 7).

Most of the questions were answered by >50 % of students in both groups except two questions. One was from ‘true/false’ category i.e. ‘The whole eyeball is removed during donation’ (23.7% response rate, p-value=0.35) and other was from ‘yes/no’ category i.e. ‘Have you registered for eye donation’ (0.03% response rate, p-value=0.89). The response rate of both these was quite less. The first question was of a dubious response (correct response could be both true and false) as we all know that the whole eyeball is often removed from the donor for the purpose of corneal transplantation. Yet only donor corneal button harvest is also practical, successful, and is being practiced in some centers. The advantage of the removal of the whole eyeball is that other parts like the sclera can also be used for surgical and research purposes. The second question with poor response rate was of a personally directed nature. The dubious and personal nature of these questions had remained undetected even after the pilot study. Thus, to decrease bias, both of these were removed from the final analysis.

Significant differences in responses were obtained from both the groups implying the impact of studying ‘Ophthalmology subject’. These differences were in response to questions like the ideal time interval between death and enucleation {83.4% of the Group A students gave correct response versus 95.2% of Group B students (p-value=0.01)}, time taken for eye removal {78.2% of the Group A students gave correct response versus 88.6% of Group B students (p-value=0.01)}. The differences are summarised in (Table/Fig 8) in the form of gaps in knowledge. Students were more knowledgeable and sensitised to the issue after studying ‘Ophthalmology’ subject in most aspects.

Discussion

The level of knowledge and attitude of medical students are important determinants in promoting eye donation as they are future potential motivators and donors. The present study showed that 92.5% of the students were aware of the aspect of one donor providing vision for two eyes. This fact was known by 74.1% of college students and 87.5% of the general population in different studies (8),(9). The current study population knew better perhaps because MBBS students are more knowledgeable specially in biological sciences.

The timing of eye donation is important, it may not be ideal to utilize eyes that are donated later than six hours after death for optical purposes due to endothelial cell loss. In the present study, a large number of students (89.1%) knew that the ideal time for donation is within six hours of death unlike the study conducted by Dhaliwal U et al., who observed that 79.6% of medical students knew that eyes can be donated after death and 63.3% knew that it should be done within six hours (10). The low proportion of people who are aware of the optimal time to donate eyes despite awareness of eye donations suggests that a large proportion of donated eyes may not become available at the optimal time.

Only 58.38% of students knew that eyes could be donated only after death. This is a disturbing fact in comparison to a study conducted by Gupta A et al., where 96.8% of the nursing students were aware that eyes can be donated only after death (11). Other organs like kidneys or liver may be donated by a live person, however not eyeball/cornea. Also, there were three questions-pertaining to disfigurement of face, relative consent and only ophthalmic part cornea being used for transplantation-to which answers of group A were more accurate. This highlights the inconsistency and shallow depth of knowledge of students even after studying the subject. The curriculum for the medical students should thus be altered to add some videos, roleplays, and other teaching-learning methods so that students can envision the eye donation process.

Coming to next category of Multiple-Choice Question (MCQ), teachers/friends followed by books, was the most important source for awareness about eye donation among the student population. Bhandary S et al., (n=400), Krishnaiah S et al., (n=7775) and Dandona R et al., (n=2522) also did questionnaire or interview-based studies on general population; they found mass media to be major source of knowledge on eye donation in 55.7%, 79.2% and 83.3% of study population respectively (5),(12),(13). However, in a community outreach questionnaire survey on 527 adults by Priyadarshini B et al., among the adult population of South India, the major source of knowledge was publicity campaigns (105, 19,9%) (14).

The other MCQ was about who could donate eyes. There is no age bar for an eye donor. All deceased people can be considered as suitable donors except with blood-borne viral illnesses like Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV) infection, and systemic malignancies which are absolute contraindications as they may affect the recipient. But a great number of students in the present study had misconceptions about the contraindications of eye donation. About two-thirds thought that previous eye surgery and chronic diseases like hypertension or diabetes were contra-indications to eye donation. In a study conducted by Dhaliwal U et al., medical students labeled corneal diseases (85.7%), HIV (38.8%), and HBV (22.4%) as contraindications for eye donation (10). In the present study 63.4% students knew that corneal donation could not cure all types of blindness. In a study by Dhanushia G et al., three-fourths of medical and half the nonmedical students knew that corneal donation could not cure all types of blindness. The knowledge that first-degree relatives have the right to give consent for eye donation was 88.2% and 49.5% among medical and nonmedical students respectively (P < 0.01). In our study 85.9% of group A and 64.2% of group B students knew that relatives have the right to give consent for the dead (15).

The last category of questions in the questionnaire was the ‘yes/no’ category. Donors’ consent before death should form the basis for eye donation according to the Human Organ Transplantation Act 1995 (16). However, consent from adult family members of the deceased needs to be obtained. Tandon R et al., did a study on the responses of relatives of post-mortem cases; identified 159 potential donors, but only 44.3% of potential donors gave consent for donation after intensive counseling (17). The wrong perception of disfigurement of the face is one of the major reasons which restrict relatives of the deceased from eye donation. 78 % of participants in the present study knew that there occurs no disfigurement of the face after eye donation. Likewise, other studies by Dandona R et al., (n=2522), Priyadarshini B et al., (n=527) and Tandon R et al., (n=159) quoted objection by family members, disfiguring the body, donation being a time-consuming process delaying religious rites, and religious restrictions as reasons for not agreeing to donate eyes (13),(14),(17). Authors feel that medicos with their knowledge and empathetic b ehavior are a powerful medium to help overcome these inhibitions and superstitions.

It was interesting to note that 71% of students were willing to pledge their eyes. Also, we saw that group B students after studying Ophthalmology showed more readiness for eye donation. Thus, studying the subject did have an impact on their knowledge and attitude. Still, just three-fourths of the students were willing for the same, showing area that could be worked upon.

The present study’s results on knowledge and willingness to donate eyes resembled similar studies done on students from various backgrounds that varied from 64% to 87% (9),(10),(11),(14). Not surprisingly, these showed quite encouraging results. Contrarily, a study on the general population, both rural and urban was not very reassuring. In the urban population, 73.8% were aware of eye donations and only 44.9% were willing to pledge their eyes (17). This showed that literate and young students were more sensitised to the noble cause.

The strength of the present study was its large sample size. Approximately 600 students were sent the questionnaire and 527 responded. Authors removed two questions from in-depth analysis as they felt them to be unclear and of personal nature in order to decrease bias; although these remained undetected even after the pilot study. It was the first study of comparison among medical students before and after reading ‘Ophthalmology’.

Limitation(s)

The study did not take the picture of the whole population and thus cannot mimic the real situation. Also, the total number of responses for many questions was less than total respondents, maybe indicating that those who did not know, did not answer. Also, authors assumed that the difference between the groups was solely due to ‘studying Ophthalmology’ subject which may not be true. Besides, reasons for not being donors and the religion of the responder were not asked as we thought it was a personal question and could make the responder uncomfortable.

Conclusion

The present study underscores that most of the students have good knowledge of eye donation procedure and practice and studying ‘Ophthalmology’ has a significant impact on the student knowledge. By means of this study, we wish to give future recommendations that as students of medical fraternity are quite well sensitised to the issue of blindness and eye donation and major chunk get employed in private and public sectors after completing graduation, after a short training, they can be mobilised to promote the cause or even perform eye donation as they have an extensive outreach in rural and urban areas (much more than ophthalmologists). Thus, a highly potential ‘cornea retrieval chain’ can be formed that increases the cornea donation manifold. This can decrease the root problem of avoidable corneal blindness. Moreover, there is a social stigma attached to eye donation; MBBS students because of the nature of their they can convince others to overcome it.

References

1.
Thylefors B, Négrel AD, Pararajasegaram R, Dadzie KY. Global data on blindness. Bull World Health Organ. 1995;73(1):115-21.
2.
Ackland P, Resnikoff S, Bourne R. World blindness and visual impairment: despite many successes, the problem is growing. Community Eye Health. 2017;30(100):71-73.
3.
NPCBVI. [cited 2022Sep23]. Available from: https://npcbvi.mohfw.gov.in/.
4.
Gupta N, Tandon R, Gupta SK, Sreenivas V, Vashist P. Burden of Corneal Blindness in India. Indian J Community Med. 2013;38(4):198-06. [crossref] [PubMed]
5.
Krishnaiah S, Kovai V, Nutheti R, Shamanna BR, Thomas R, Rao GN, et al. Awareness of eye donation in the rural population of India. Indian J Ophthalmol. 2004;52(1):73-78.
6.
Acharya M, Farooqui JH, Dave A, Chaku D, Ganguly KK, Das A, et al. Eye donation in North India: Trends, awareness, influences and barriers. Indian J Ophthalmol. 2019 ;67(10):1570-04 [crossref] [PubMed]
7.
Sharma B, Shrivastava U, Kumar K, Baghel R, Khan F, Kulkarni S, et al. Eye donation awareness and conversion rate in hospital cornea retrieval programme in a tertiary hospital of Central India. J Clin Diagn Res. 2017;11(8):NC12-15. [crossref] [PubMed]
8.
Manhas A, Gupta D, Kumar D, Manhas RS, Manhas GS. Awareness regarding eye donation among patients atending tertiary care hospital, Jammu, J&K, North India-Time to educate people. Int J Contemp Med Res. 2018;5(12):15-18. [crossref]
9.
Vallinayagam M, Kumar PS, Krishnamoorthy J, Arumugam R. A study on eye donation awareness among medical and engineering students in Puducherry. DJO. 2017;28:20-24. [crossref]
10.
Dhaliwal U. Enhancing eye donation rates. Training students to be motivators. Indian J Ophthalmol. 2002;50(3):209-12.
11.
Gupta A, Jain S, Jain T, Gupta K. Awareness and perception regarding eye donation in students of a Nursing College in Bangalore. Indian J Community Med. 2009;34(2):122-25. [crossref] [PubMed]
12.
Bhandary S, Khanna R, Rao KA, Rao LG, Lingam KD, Binu V. Eye donation- awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia. Indian J Ophthalmol. 2011;59(1):41-45. [crossref] [PubMed]
13.
Dandona R, Dandona L, Naduvilath TJ, McCarty CA, Rao GN. Awareness of eye donation in an urban population in India. Aust N Z J Ophthalmol. 1999;27(3- 4):166-69. [crossref] [PubMed]
14.
Priyadarshini B, Srinivasan M, Padmavathi A, Selvam S, Saradha R, Nirmalan PK, et al. Awareness of eye donation in an adult population of southern India. A pilot study. Indian J Ophthalmol. 2003;51(1):101-04.
15.
Dhanushia G, Sahu P, Sanjana E, Mishra A. Awareness on eye donation among medical and nonmedical students: A cross-sectional comparative study. J Curr Res Sci Med. 2021;7(2):108. [crossref]
16.
Transplantation of human organs acts and rules: Ministry of health and family welfare: GOI [Internet]. Ministry of Health and Family Welfare | GOI. [cited 2022Sep23]. Available from: https://main.mohfw.gov.in/acts-rules-and-standards-health-sector/ acts/transplantation-human-organs-acts-and-rules.
17.
Tandon R, Verma K, Vanathi M, Pandey RM, Vajpayee RB. Factors affecting eye donation from postmortem cases in a tertiary care hospital. Cornea. 2004;23(6):597-01. [crossref] [PubMed]

DOI and Others

DOI: 10.7860/JCDR/2023/59438.17334

Date of Submission: Aug 03, 2022
Date of Peer Review: Sep 27, 2022
Date of Acceptance: Nov 26, 2022
Date of Publishing: Jan 01, 2022

AUTHOR DECLARATION:
• 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. No

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 05, 2022
• Manual Googling: Nov 19, 2022
• iThenticate Software: Nov 24, 2022 (18%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com