A perspectiva do consumo de plantas medicinais porpacientes idosos em tratamento quimioterápico / The perspective of the consumption of medicinal plants byelderly patients undergoing chemotherapy treatment

O câncer, frequentemente relacionado ao envelhecimento, impulsiona pacientes a buscarem tratamento hospitalar ou métodos alternativos, como plantas medicinais. Este estudo visou avaliar os perfis sociodemográfico e clínico e o consumo de plantas para fins medicinais entre pacientes idosos em tratamento oncológico no Hospital Araújo Jorge (HAJ). Dados de 55 pacientes foram analisados, abrangendo informações sociodemográficas, tipos de câncer, tratamento, a utilização de plantas medicinais, o objetivo de uso, as fontes de informações sobre plantas e se notaram alguma reação adversa após o consumo. A faixa etária mais encontrada foi 61 a 70 anos (67,27%), a maioria dos pacientes eram homens (63,64%), com ensino fundamental incompleto (32,73%), casados (56,36%) e que moram no interior de Goiás (43,64%). Quanto ao tratamento, a maioria realizava quimioterapia (40,00%) e o câncer gástrico foi mais relatado (14,54%). Sobre o uso de plantas medicinais, a maioria relatou simpatizar com o consumo (58,18%), e acredita em sua segurança devido à origem natural (59,37%). Informações sobre o uso de plantas medicinais eram obtidas com amigos, vizinhos e familiares (21,81%). Ao relatar sobre o consumo de plantas medicinais durante a quimioterapia, a maioria não percebeu nenhum efeito (40,63%). Foram citadas 17 plantas, que eram utilizadas no tratamento anticâncer (29,00%) e preparadas como infusões (18,75%) pelo uso das folhas frescas (60,00%), principalmente para uso interno (46,87%). Diante disso, a atenção farmacêutica se mostra vital para guiar pacientes nas práticas seguras e eficazes de consumo. Isso inclui direcionar sobre doses adequadas, efeitos colaterais e interações, garantindo bem-estar e prevenindo riscos à saúde.

Cancer, which is often related to ageing, drives patients to seek hospital treatment or alternative methods such as medicinal plants. This study aimed to evaluate the sociodemographic and clinical profile and the consumption of plants for medicinal purposes among elderly patients undergoing cancer treatment at the Araújo Jorge Hospital (AJH). Data from 55 patients was analyzed, covering sociodemographic information, types of cancer, treatment, the use of medicinal plants, the purpose of use, the source of information about plants and whether they noticed any adverse reactions after consumption. The most common age group was 61 to 70 years (67.27%), the majority of patients were men (63.64%), had incomplete primary education (32.73%), were married (56.36%) and lived in the interior of Goiás (43.63%). With regard to treatment, the majority were undergoing chemotherapy (40,00%) and gastric cancer was the most frequently reported (14.54%). With regard to the use of medicinal plants, the majority were sympathetic to their consumption (58.18%) and believed them to be safe due to their natural origin (59.37%). Information on the use of medicinal plants was obtained from friends, neighbors and family members (21.81%). When reporting on the consumption of medicinal plants during chemotherapy, the majority did not notice any effect (40.63%). Seventeen plants were mentioned, which were used for anticancer treatment (29,00%) and prepared as infusions (18.75%) with fresh leaves (60,00%), mainly for internal use (46.87%). In view of this, pharmaceutical care is vital to guide patients in safe and effective consumption practices. This includes guidance on appropriate doses, side effects and interactions, ensuring well-being and preventing health risks.

Red kratom and red corvette: A case of mania induced by kratom withdrawal.

Background: Kratom, derived from the Mitragyna speciose, a  plant native to Southeast Asia, is a substance that is gaining popularity in the United States as a self-medication tool for opiate withdrawal and pain management. Its active compounds, mitragynine, and 7-hydroxymitragynine, interact with various receptors in the body, resulting in a spectrum of clinical effects.Case: A 56-year-old male with a history of depression and cannabis use disorder arrived at the Emergency Department in a state of severe agitation with erratic behavior and aggression. Further evaluation revealed a recent abrupt discontinuation of Kratom use. A psychiatric consultation was requested and done by our consultation-liaison team, diagnosing Kratom withdrawal as the most likely cause of his acute mania. Neuropsychiatric symptoms arising from Kratom toxicity is a well-documented phenomenon; however, to our knowledge, this may be the first documented case of acute mania induced by Kratom withdrawal.

Assessment of factors associated with self-medication practices during the COVID-19 pandemic in southwestern Ethiopia: a community-based cross-sectional survey.

BACKGROUND: Self-medication practices involve the use of medications without healthcare professional requests. The threat of coronavirus disease 2019 (COVID-19) caused the practice of a fittest to survive action, with the assumption that something is better than nothing. Moreover, owing to the lack of effective treatment for COVID-19, the general public has shifted toward self-medication and symptomatic treatment, with approximately 80% of people stockpiling medication for use during the pandemic. Thus, this study aimed to assess the factors associated with self-medication practices during the COVID-19 pandemic crisis in southwestern Ethiopia. METHODS: A community-based cross-sectional study design was employed at selected drug retail outlets in southwestern Ethiopia for 415 community pharmacy clients from July 1, 2021, to September 1, 2021. Purposive sampling techniques were employed to select five drug retail outlets on the basis of high patient flows, and we took the study participants until the required quota allotted to each selected drug retail outlet had been filled. Bivariable and multivariable logistic regression analyses were employed to identify factors associated with self-medication. AORs with 95% CIs were used to report associations, and the level of significance was set at P < 0.05. RESULTS: Self-medication was significantly associated with being female (AOR 3.51, 95% CI 1.04-12.41), having a college education or above (AOR 47, 95% CI 4.32-55.21), time wastage at public health facilities (AOR 2.71, 95% CI 3.47-5.21), being afraid of contracting COVID-19 (AOR 0.006, 95% CI 0.004-0.185), and having high fees at public health facility (AOR 0.006, 95% CI 0.004-0.185). The most frequently used medications to treat or prevent the COVID-19 pandemic were analgesics (42.4%) and cold medicines (29.5%). Headache (22.2%), fever (13.2%), respiratory infection (14.3%), and cold (21.4%) were the most frequently reported symptoms of the COVID-19 pandemic. CONCLUSION: This study revealed high self-medication practices among study area residents during the COVID-19 pandemic. The primary reasons for self-medication in the context of COVID-19 are fear of the pandemic and time wastage at public health facilities. Therefore, special attention should be given to educating public and health care providers on the types of illnesses that can be self-diagnosed and self-treated and the types of drugs to be used for self-medication.

Self-medication, self-assessment and knowledge of dental medicine students about analgesics.

Background: The objective of this study was to investigate the rate of self-medication among dental students and any differences and/or associations between self-medication, self-assessment and knowledge among students in later years of the same study. Material and Methods: The study was conducted between April and July 2020 at the School of Dental medicine, University of Zagreb. All students were given access to an online survey to learn more about their self-medication habits, pharmacological knowledge and analgesic self-assessment. The experimental research group consisted of 120 third- to sixth-year students (n = 120), while the control group consisted of 30 first- and second-year students who had not taken any pharmacology courses. Results: Even 110 students (91.67%) reported self-medication, with ibuprofen being the most prevalent analgesic (70%). Fifth-year students showed a statistically significant difference in all knowledge-related questions compared to third- and fourth-year students (p=0.0015 and p=0.002, respectively). In addition, in the self-assessment statements across all study years, a statistically significant difference (p<0.05) was also noticed. The feeling of willingness to prescribe analgesics behaved according to the increasing pattern over the years of study. Conclusions: A statistically significant difference in self-medication, self-assessment and knowledge among dental students over the years, with the alarmingly high prevalence of self-medication among them, was observed. Because effective dental practice requires a thorough knowledge of pharmaceuticals, it is vital to continually expand and refine students' understanding of the use of analgesics in dentistry throughout their undergraduate studies. Key words:Analgesics, Self Medication, Self-Assessment, Knowledge, Dentistry, Students.

Structured over-the-counter medicine dataset to improve the safety of pharmaceuticals.

The Pharma-safe Index Dataset comprises comprehensive information on several aspects of pharmaceuticals, including general medication data, usage guidelines, dosage, adverse effects, pricing, drug interactions, duration of use, composition, and contraindications. The dataset is provided in both CSV and JSON file formats, and it is available in both English and Bahasa Indonesia. By conducting interviews, distributing flyers, and using pharmacy books, the dataset was collected from over-the-counter medications that were sold at three pharmacies located in Yogyakarta, Indonesia. A medical professional performed cleansing, standardization, and validation on it before it was exported to JSON and CSV formats. The data collected on drug efficacy, safety, and patient outcomes in Indonesia can be utilized by researchers in order to uncover trends and developing patterns of prescription drug resistance. It is possible that this will direct future research, lead to improvements in drug formulations, treatment strategies, and public health policies, and expand our understanding of how drugs work and how they affect patient health.

Self-medication in medical students in urban India: Exploring the extent of this dangerous practice.

Objectives: To assess the prevalence of self-medication in urban Indian medical students and explore possible factors associated with this practice. Methods: After obtaining institutional ethics approval, 180 medical students from six medical colleges in Mumbai were recruited to participate via social media. They were administered a pre-validated questionnaire that assessed self-medication as a practice, along with the perceived stress scale (PSS-10) online. Anonymity and confidentiality were maintained. Results: The prevalence of self-medication in medical students was found to be 83.9%, with no significant difference between genders or between academic years of medical education. The most used source of information for self-medicating was older prescriptions, and for procuring drugs was pharmacist stores. Common cold was the most cited indication. Anti-pyretics and anti-inflammatory drugs were the most commonly self-medicated drugs. It was found that 73.3% of medical students had self-medicated with non-over-the-counter (OTC) drugs. It was observed that 6.1% of medical students had experienced adverse drug reactions, and alarmingly, 0.6% of medical students continued self-medicating despite experiencing adverse drug reactions. Conclusions: Most of the study participants admitted to having practised self-medication. It was alarming to find that an appreciable fraction of the study population had uncontrolled access to non-OTC drugs. Thus, there needs to be a greater emphasis on the education of medical students with respect to the problems encountered by self-medicating and a need to enforce stricter regulations, as well as to establish a more watertight monitoring system, to curb this hazardous practice.

Antibacterial and antioxidant activities of plants consumed by western lowland gorilla (Gorilla gorilla gorilla) in Gabon.

Zoopharmacognosy is the study of the self-medication behaviors of non-human animals that use plant, animal or soil items as remedies. Recent studies have shown that some of the plants employed by animals may also be used for the same therapeutic purposes in humans. The aim of this study was to determine the antioxidant and antibacterial activity of Ceiba pentandra, Myrianthus arboreus, Ficus subspecies (ssp.) and Milicia excelsa bark crude extracts (BCE), plants consumed by western lowland gorillas (Gorilla gorilla gorilla) in Moukalaba-Doudou National Park (MDNP) and used in traditional medicine, and then to characterize their phytochemical compounds. DPPH (2,2-Diphenyl-1-Picrylhydrazyl), phosphomolybdenum complex and ß-carotene bleaching methods were used to assess antioxidant activity. Antimicrobial susceptibility testing was performed using the diffusion method, while minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were assessed using the microdilution method. The highest level of total phenolics was found in Myrianthus arboreus aqueous extract [385.83 ± 3.99 mg [gallic acid equivalent (GAE)/g]. Total flavonoid (134.46 ± 3.39) mg quercetin equivalent (QE)/100 g of extract] were highest in Milicia excelsa, tannin [(272.44 ± 3.39) mg tannic acid equivalent (TAE)/100 g of extract] in Myrianthus arboreus and proanthocyanidin [(404.33 ± 3.39) mg apple procyanidins equivalent (APE)/100 g of extract] in Ceiba pentandra. Ficus ssp. (IC50 1.34 ±3.36 µg/mL; AAI 18.57 ± 0.203) ethanolic BCE and Milicia excelsa (IC50 2.07 ± 3.37 µg/mL; AAI 12.03 ± 0.711) showed the strongest antioxidant activity. Myrianthus arboreus ethanolic BCE (73.25 ± 5.29) and Milicia excelsa aqueous BCE (38.67 ± 0.27) showed the strongest percentage of total antioxidant capacity (TAC). Ceiba pentandra ethanolic BCE (152.06 ± 19.11 mg AAE/g) and Ficus ssp aqueous BCE (124.33 ± 39.05 mg AAE/g) showed strongest relative antioxidant activity (RAA). The plant BCE showed antimicrobial activity against multidrug resistant (MDR) E. coli (DECs) isolates, with MICs varying from 1.56 to 50 mg/mL and inhibition diameters ranging from 7.34 ± 0.57 to 13.67 ± 0.57mm. Several families of compounds were found, including total phenolic compounds, flavonoids, tannins and proanthocyanidins were found in the plant BCEs. The plant BCEs showed antioxidant activities with free radical scavenging and antimicrobial activities against 10 MDR E. coli (DECs) isolates, and could be a promising novel source for new drug discovery.

Health checkup practice and its associated factors among adults in South Gondar zone Ethiopia.

Non-communicable diseases are the current global burden including in sub-Saharan Africa, which increasing the incidence of cardiovascular disorders and their complications due to a lack of health checks and delayed treatments. To assess health checkup practice among adults in the South Gondar zone of northeast Ethiopia in 2022. A community-based cross-sectional study design was employed from July 30, 2022, to August 30, 2022. Three woredas (Debre Tabor, Guna Beyemidir, and Andabet) were selected by using a simple random sampling method from the south Gondar zone, and three kebeles were selected randomly from each woreda. A complete of 422 samples were selected by random sampling technique. Data were collected in a face-to-face interview using structured questionnaires. The collected data were entered into Epi data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 26 for analysis. Binary logistic regression was done to identify the association between each variable with the outcome variable. A variable that had a p-value < 0.25 in binary logistic regression became a candidate for multivariate logistic regression then after factors p value < 0.05 was considered as predictors to the outcome variable. In this study, health checkup practice was 40.2%. Living with families (AOR 3.36; 95% CI 1.47-7.66), presence chronic disease (AOR 2.52; 95% CI 1.49-4.26), No self-medication practice (AOR 5.39; 95% CI 3.06-9.49) and having health insurance (AOR 3.02; 95% CI 1.68-5.430) were significantly associated with regular health checkup practice. Health checkup practice was low as compared to health policy recommendations and its health maintenance value. Creating awareness about health check-ups and prevention of disease complications will be taken by different stakeholders in the health care system.

Ergonomic challenges of mortuary attendants in Ghana: an exploratory study.

Objective. Mortuary attendants in Ghana face various occupational health and safety hazards, including ergonomic and psychosocial factors, which can impact both their well-being and the quality of service provided. However, there is limited knowledge about the specific ergonomic hazards they encounter. This study aims to investigate and understand these ergonomic hazards at selected hospital mortuaries in Ghana. Methods. The study used a qualitative approach to investigate the experiences of 19 mortuary attendants, selected through purposive sampling. Semi-structured interviews were conducted and recorded digitally, and focused on participants' demographics, work experiences, challenges and coping strategies. The collected data were transcribed verbatim and analyzed thematically. Results. The study found that mortuary attendants face ergonomic hazards, leading to physical discomfort, sleep problems and the need for sick leave and self-medication. Poor working conditions were a major risk factor. Conclusion. The study recommends the immediate inclusion of fundamental occupational health and safety practices into the informal apprenticeship training for mortuary attendants. Additionally, the study underscores the importance of providing necessary equipment to mortuary attendants to reduce or eliminate ergonomic hazards in their work environments.

Review: Herbivory and the power of phytochemical diversity on animal health.

Plant secondary compounds (PSCs) were thought to be waste products of plant metabolism when first identified in the mid-1800 s. Since then, many different roles have been recognized for these chemicals. With regard to their function as defense, PSCs can negatively impact different cellular and metabolic processes in the herbivore, causing illness and reductions in feed intake. This penalty on fitness also applies to other trophic levels, like the microorganisms and parasites that infect herbivores and thus, PSCs at certain doses may function as medicines. In turn, herbivores evolved learning mechanisms to cope with the constant variability in their environment and physiological needs. Under this context, foraging can be viewed as the quest for substances in the external environment that provide homeostatic utility to the animal. For instance, herbivores increase preference for PSC-containing feeds that negatively impact infectious agents (i.e., therapeutic self-medication). Given that some classes of PSCs like polyphenols present antioxidant, antiinflammatory, immunomodulatory and prebiotic properties, chronic and sustained consumption of these chemicals results in robust animals that are tolerant to disease (i.e., prophylactic self-medication). Foraging plasticity in terms of the quality and quantity of nutrients ingested in the absence and during sickness may also influence immunocompetence, resistance and resilience to infection, and thus can be interpreted as another form of medication. Finally, self-medicative behaviors can be transmitted through social learning. We suggest that foraging studies will benefit from exploring self-medicative behaviors in chemically diverse plant communities, in particular when considering the vast diversity of PSC structures (more than 200 000) observed in nature. We then lay out a framework for enhancing the medicinal effects of PSCs on grazing herbivores. We propose landscape interventions through the establishment of resource patches or "islands" with a diversity of PSC-containing forages (e.g., legumes, herbs, shrubs) in monotonous rangelands or pasturelands, viewed as a "sea" of low-diversity vegetation devoid of functional biochemicals. Strategies aimed at enhancing the diversity of plant communities lead to heterogeneity in chemical, structural and functional landscape traits that offer options to foragers, and thus allow for balanced diets that maintain and restore health. Beyond animal health, such heterogeneity promotes a broad array of ecosystem services that significantly improve landscape resilience to environmental disturbances.

Analysis of care-seeking pathways and factors influencing early and appropriate care-seeking for malaria patients in the Republic of Guinea: a cross-sectional study.

BACKGROUND: Malaria is a major public health issue in Guinea and care-seeking behaviour is dominated by self-medication and delayed access to appropriate care. However early and appropriate care-seeking are essential to control and reduce complicate forms and mortality, particularly for the most vulnerable. This study was conducted to analyse the diagnostic pathway, and the factors associated with early and appropriate care-seeking for malaria patients in the Republic of Guinea. METHODS: A cross-sectional study was carried out between December 2022 to March 2023 in nine health districts within health facilities and at community level. The study population was confirmed malaria patients with RDT or microscopy. Kroeger's conceptual framework was used to design the questionnaire. Conventional recourse was defined as using a healthcare facility or community services, early and appropriate care-seeking was defined as within 24 h of symptom onset in a conventional recourse, and care pathway as the sequence of recourses followed by each patient. Sankey alluvial plots were used to represent patients' diagnostic pathways, and logistic regression to identify factors associated with early and appropriate care-seeking. RESULTS: A total of 3300 malaria patients were studied, of which 1632 (49.45%) were female and 1132 (34.30%) were under 5 years of age, with a median age of 23 months. At the time of the survey, 1337 (40.52%), 1423 (43.12%), and 437 (13.85%) of patients were respectively in their first, second and third recourse. A total of 2002 (60.67%) patients had sought care from a conventional recourse as a first line. Of all patients, 1757 (53.25%) had sought care within 24 h, while 28.55% had sought early and appropriate care. In the initial stages of treatment, self-medication was the most common approach, used by 1214 (37.30%). Patients from the health districts of Boffa (Lower Guinea, coastal region) OR = 0.48 95% CI 0.33-0.70, Dabola (Upper Guinea, savanna region) OR = 0.43 95% CI 0.30-0.63 and Labe (Middle Guinea, mountain region) OR = 0.63 CI 95% 0.43-0.91 (p < 0.05) were more likely to delay appropriate care-seeking, when compared to those in Dixinn, (Conakry). However, the under 5-year-old group OR = 1.55 95% CI 1.30-1.85 (p < 0.001) and the availability of a stable monthly household income OR = 4.98 95% CI 3.03, 8.27 (p < 0.001) were positively associated with early and appropriate care seeking. CONCLUSION: A low rate of early and appropriate care-seeking was observed. Patients sought care through multiple means, often resulting in a delay in adequate management. The results show the need to deploy strategies adapted to the needs of communities.

Self-medication for dental caries-associated toothache among dental outpatients attended at public health facilities in Dar es Salaam, Tanzania: A cross-sectional study.

Background and aim: Self-medication is a common practice worldwide, and its prevalence ranges between 20% and 80% among patients suffering from dental pain. The socioeconomic status of an individual plays a key role in self-medication practice, especially sex and education level. This study aims to investigate the extent of self-medication practice for toothache due to dental caries among adults in Dar es Salaam, Tanzania. Methods: This was an analytical cross-sectional study carried out over 6 months. It included adult patients presenting with toothache in public dental clinics. A questionnaire captured information on demography, self-medication practice, the substance used for self-medication, duration of self-medication, and reason for self-medication. Univariate analysis was carried out to assess factors associated with self-care remedies. The probability level of α < 0.05 was selected for statistical significance. Results: A total of 420 participants took part in this survey with a majority (54.3%) being females. The ages of the participants ranged between 18 years and 79 years, with a mean age of 33.37 (SD = 12.64) years. Nearly all (98.5%) participants used some sort of self-prescribed remedies for managing toothache before attending a dental clinic for appropriate treatment. The sociodemographic status of the participants did not influence the practice of self-medication. Conclusion: About 98% of patients suffering from toothache in Tanzania practice self-medication, and it cuts across all social strata of the adult dental population. Patient or Public Contribution: Patients with toothache secondary to dental caries participated in the pilot study and were consulted on the suitability of the study tool.

O que é automedicação e quais os riscos desta prática? | Coisa de Homem

Diz o ditado que "de médico e louco, todo mundo tem um pouco", mas por mais simples que sua dor pareça, tomar remédios por conta própria pode trazer problemas de saúde ainda piores. Saiba mais no vídeo de hoje!

Indirect victims of violence: a look at health impacts. / Vítimas indiretas da violência: um olhar sobre os impactos na saúde.

We sought to investigate the perceptions of indirect victims or family members of homicide victims, about the repercussions of these deaths on their health. A qualitative, exploratory, descriptive study was carried out, based on eight semi-structured individual interviews with two groups: family members of police officers victimized by lethal violence, and family members of people killed as a result of police intervention, designated here as homicide. Both groups reported the perception that their health deteriorated after the homicide, and mentioned problems such as depression, panic disorder, insomnia, heart conditions and eating disorders. They also highlighted the acquisition of habits that are harmful to health, such as the consumption of alcoholic beverages, tobacco and self-medication, and the worsening of pre-existing health issues. It was observed that the homicide committed and suffered by police agents affects various aspects of the lives of indirect victims that are inseparable from health issues in a broader sense. These people are also victims of this violence, although their suffering is often made invisible. Studying this topic helps to give space to the suffering and mourning of these people and to subsidize the best performance of the institutions and services involved.

Buscou-se investigar as percepções das vítimas indiretas, ou familiares de vítimas de homicídio, sobre as repercussões dessa morte em sua saúde. Fez-se um estudo qualitativo, exploratório, descritivo, a partir de oito entrevistas individuais semiestruturadas com dois grupos: familiares de agentes policiais vitimados por violência letal, e familiares de pessoas mortas em decorrência de intervenção policial, aqui designada como homicídio. Ambos os grupos relataram a percepção de que sua saúde piorou após o homicídio, e mencionaram problemas de depressão, síndrome do pânico, insônia, problemas cardíacos e distúrbios alimentares. Destacaram ainda a aquisição de hábitos danosos à saúde, como consumo de bebidas alcoólicas, tabaco e automedicação, e o agravamento de problemas de saúde pré-existentes. Observou-se que o homicídio praticado e sofrido por agentes policiais afeta vários aspectos da vida das vítimas indiretas que são indissociáveis das questões de saúde em sentido ampliado. Essas pessoas também são vítimas dessa violência, embora muitas vezes tenham seu sofrimento invisibilizado. Estudar o tema contribui para dar espaço ao sofrimento e ao luto, e para subsidiar a melhor atuação das instituições e serviços envolvidos.

Exploring drivers of self-treatment with antibiotics in three agricultural communities of northern Tanzania.

BACKGROUND: Antimicrobial resistance (AMR) poses a significant global health threat, particularly in low- and middle-income countries (LMICs). Self-treatment with antibiotics, the practice of using antibiotics without professional guidance, is often considered an important contributor to the emergence and spread of AMR. METHOD: This study investigated the drivers of self-treatment in three common types of agricultural communities in northern Tanzania. The research employed a comprehensive array of methods, including cross-sectional surveys (n = 790), interviews (n = 30) and observations (n = 178) targeting both antibiotic (human and animal) providers and users (patients and farmers). Qualitative interview data were analysed using a coding and association matrix, while descriptive analyses were performed on survey and observation data. RESULTS: Self-treatment with antibiotics was highly prevalent in all communities. Between 41.0% (self-reported) and 60.3% (observed) of human antibiotics were obtained without a prescription and we observed that veterinary antibiotics were regularly purchased in retail shops without referral by a professional. Structural deficiencies in the healthcare system drove this practice: limited access to healthcare facilities, medication stockouts and prolonged waiting times were identified as key factors. The absence of safety nets like insurance schemes further contributed to self-medication. Retail shops offered a convenient and cost-effective alternative when antibiotics were inaccessible or unaffordable. Notably, informal networks comprising treatment vendors, friends or neighbours, as well as personal experiences played a crucial role in guiding individuals in their self-treatment decisions by providing advice on treatment choice and modalities. CONCLUSIONS: Addressing self-treatment requires a multi-faceted approach. Improving the availability and accessibility of antibiotics, enhancing healthcare services and involving retail vendors in antibiotic stewardship are essential. Structural issues like access to diagnostics and medicines must be tackled, alongside reducing barriers and incentivising individuals to use professional healthcare services. Training retail vendors to sell specific first-line antibiotics over the counter with guidance on appropriate usage should be considered. Such bottom-up interventions will enable sustainable promotion of responsible antibiotic use, mitigating AMR emergence and securing a healthier future for all.

Development and validation of a predictive model for acute kidney injury in patients with ureterolithiasis.

OBJECTIVES: This study aims to identify risk factors for acute kidney injury (AKI) in patients with ureterolithiasis and to develop a predictive model for early AKI detection in this population. METHODS: A retrospective analysis was conducted on data from 1,016 patients with ureterolithiasis who presented to our outpatient emergency department between January 2021 and December 2022. Using multifactorial logistic regression, we identified independent risk factors for AKI and constructed a nomogram to predict AKI risk. The predictive model's efficacy was assessed through the area under the ROC curve, calibration curves, Hosmer-Lemeshow (HL) test, and decision curve analysis (DCA). RESULTS: AKI was diagnosed in 18.7% of the patients. Independent risk factors identified included age, fever, diabetes, hyperuricemia, bilateral calculi, functional solitary kidney, self-medication, and prehospital delay. The nomogram demonstrated excellent discriminatory capabilities, with AUCs of 0.818 (95% CI, 0.775-0.861) for the modeling set and 0.782 (95% CI, 0.708-0.856) for the validation set. Both calibration curve and HL test results confirmed strong concordance between the model's predictions and actual observations. DCA highlighted the model's significant clinical utility. CONCLUSIONS: The predictive model developed in this study provides clinicians with a valuable tool for early identification and management of patients at high risk for AKI, thereby potentially enhancing patient outcomes.

Key modifiable risk factors for self-medication among university students: An observational study.

Background: Self-medication among university students is becoming a health concern, especially during examinations and stress. This pattern of medication use among students could lead to adverse health consequences if it is not addressed and tackled. Thus, this study investigated the most associated factors with this practice among students. Methods: An observational cross-sectional study was conducted among university students in Northern Borders Province, Saudi Arabia. A total of 220 students were selected and took part in the survey. Data was collected through a self-administered questionnaire. The survey was distributed among participants to answer five sections: demographic and socioeconomic characteristics, health status problems, satisfaction with academic performance, and self-medication questions. The content validity was tested using a pilot sample of 30 students. The descriptive, univariate, and multivariate analyses were conducted using the Statistical Package for Social Science program. Results: In the present sample of university students, the response rate was 100%. Approximately one-third reported using medications without prescriptions, and 83% of them have used medications three times at most during the past 12 months. Headache was the most common reason for use (59%), followed by fever (20%). Adjusted multivariate analysis showed that students who were 21-24 years of age (OR = 3.79, 95% CI = 1.21-11.82), female (OR = 2.43, 95% CI = 1.03-5.72), and living alone in private housing (OR = 3.62, 95% CI = 1.32-9.90) were at high risk of self-medication as compared to their counterparts. However, students in the last years of college (fourth (OR = 0.14, 95% CI = 0.03-0.62), fifth (OR = 0.21, 95% CI = 0.05-0.95), sixth (OR = 0.05, 95% CI = 0.01-0.35)) were at lower risk as compared to their counterparts. Conclusion: The study found that self-medication was common among university students, with higher rates among those who were 21-24 years old, female, and living alone in private housing, but lower rates among students in the later years of college. Educational programs and awareness campaigns should target students who are at higher risk of practicing self-medication to avoid misuse of over-the-counter medications.

Self-Medication Paths: A Descriptive Study Unveiling the Interplay Between Medical and Non-medical Cannabis in Chronic Pain Management.

OBJECTIVES: Cannabis is used by one-third of people living with chronic pain to alleviate their symptoms despite warnings from several organizations regarding its efficacy and safety. We currently know little about self-medication practices (use of cannabis for therapeutic purposes without guidance), mainly since the legalization of recreational cannabis in countries such as Canada has expanded the scope of this phenomenon. This study aimed to describe legal cannabis self-medication for pain relief in people living with chronic pain and to explore perceptions of the effectiveness and safety of cannabis. METHODS: A cross-sectional descriptive study was performed among 73 individuals living with chronic pain and using cannabis (Quebec, Canada). Data collection using telephone interviews occurred in early 2023. RESULTS: Results indicated that 61.6% of participants reported using cannabis without the guidance of a healthcare professional (self-medication). Surprisingly, among those, 40.0% held a medical authorization. Overall, 20.6% of study participants were using both medical and legal non-medical cannabis. Different pathways to self-medication were revealed. Proportion of women vs. men participants self-medicating were 58.2% vs. 70.6% (P=0.284). In terms of perceptions, 90.4% of the sample perceived cannabis to be effective for pain management; 72.6% estimated that it posed no or minimal health risk. DISCUSSION: Cannabis research is often organized around medical vs. non-medical cannabis but in the real-world, those two vessels are connected. Interested parties, including researchers, healthcare professionals and funding agencies, need to consider this. Patients using cannabis feel confident in the safety of cannabis, and many of them self-medicate, which calls for action.

Self-medication of adults and children in Poland - results from outpatient health care physicians online questionnaire.

Introduction: In Poland, the area of self-medication requires scientific and organizational evaluation. So far, no solutions sanctioning self-medication have been introduced. Therefore, the aim of this study was to recognize and analyze the practical experience of outpatient physicians regarding self-medication of their patients, as well as self-medication of children by their caregivers. Methods: This study enrolled 386 participants and used a Computer-Assisted Web Interview that was disseminated online from 4th of July 2023 to 23rd of August 2023. The survey was addressed to outpatient healthcare physicians working in Poland. Results: In doctors' perspective the main three reasons for choosing self-medication in Poland were: taking advice from other people - family members or friends (59.1%), finding information regarding treatment online (52.9%) and ability to self-medicate in this kind of symptoms/disease (51.6%). Among adult patients, in 72.1% of cases, an independent decision to start antibiotic therapy was made. Such a decision occurred in 39.8% of pediatric patients. Children caregivers were more likely to visit the physician immediately with symptoms than in the case of adult patients (42.2% vs. 22.1%, p < 0.001). Conclusions: Self-medication in Poland requires educational and organizational support at various levels - both social (information campaigns, school education), the healthcare system (increasing the role of medical professionals, including pharmacists), and finally in the area of legislation. Two areas seem to be particularly alarming - the use of antibiotics by adults and children and the mental health of both populations.