Prevalence and associated factors of self-medication in worldwide pregnant women: systematic review and meta-analysis.

BACKGROUND: Self-medication during pregnancy is of great interest. The use of drugs during pregnancy requires a careful reflection on the benefits to the mother and the risks to the fetus. Selecting a drug or drugs for treating pregnant women can be difficult for clinicians owing to the various pharmacokinetic and physiological changes encountered during pregnancy. This systematic review and meta-analysis aimed to estimate the pooled prevalence of self-medication and associated factors among women during pregnancy. METHODS: Searches were carried out at PubMed, Science Direct, Web of Science, and Google Scholar. The quality of the studies and the risk of bias were analyzed using the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The extracted data were tabulated and analyzed qualitatively and quantitatively through meta-analysis. RESULTS: The overall prevalence of self-medication among pregnant women was 44.50% (95% CI: 38.92-50.23). Subgroup analyses showed differences in self-medication prevalence influenced by region, county income, and study design. The Heterogeneity, assessed by the statistical test I2 varied from 96 to 99% and was statistically significant. The result of this funnel plot showed that the funnel plot was symmetry with p-value = 0.36, and there is no publication bias. CONCLUSION: The results obtained from this study showed that the prevalence of self-medication among pregnant women is relatively high. This requires effective measures and interventions to reduce self-medication. TRIAL REGISTRATION: ID = CRD42022312333 .

Prevalence, motivation, and associated factors of medicinal herbs consumption in pregnant women from Eastern Mediterranean Regional Office: a systematic review.

CONTEXT: Worldwide access to medication remains a major public health problem that forces pregnant women to self-medicate with several sources, such as medicinal plants. This alternative medicine is increasing in many low- and high-income countries for several reasons. OBJECTIVE: This a systematic literature review on the prevalence of herbal use during pregnancy from the World Health Organization (WHO) Eastern Mediterranean Regional Office. METHODS: Cross-sectional studies were searched from January 2011 to June 2021 on PubMed, Scopus, and Web of Science. We used the Rayyan website to identify the relevant studies by screening the abstracts and titles. These were followed by reading the full texts to identify the final studies to be included. The data were extracted, and the quality of the studies was assessed using the quality appraisal tool. RESULTS: Of the 33 studies included in this review, 19 were conducted in Iran, 5 in Saudi Arabia, 4 in Palestine, 2 in Egypt, and 1 each in Oman, Iraq, and Jordan; the prevalence of herbal medicine use among pregnant women varied from 19.2% to 90.2%. Several plants were mentioned for pain management during the pregnancy period. The findings suggest family and friends are major motivating sources for the use of herbal medicine. CONCLUSIONS: The wide variety of herbal products used in this study reflects the traditions and geographic diversity of the region. Despite the importance of literature-based data about the use of herbal medicine, it is necessary to obtain knowledge, attitude, and motivation for herbal consumption among pregnant women.

Self-medication practice among pregnant and postpartum women attending the regional hospital center of Souss Massa, Morocco: a cross-sectional study.

Background: Self-medication among pregnant women represents a serious risk to the mother's and child's health. It is a global concern that requires careful attention from professionals in healthcare. In Morocco, there is a lack of available data on self-medication and predicting variables among pregnant and postpartum women. The purpose of this study was to determine the incidence of self-medication and the factors that contributed to it among pregnant and postpartum women in the Sous Massa Regional Hospital. Methods: A cross-sectional study was conducted using a pretested questionnaire among 420 pregnant and postpartum women who were attending the regional hospital center of the Sous Massa region from April to December 2022. Statistical analysis was performed using Jamovi Software. The logistic regression analysis was used to determine the significance of the association between the outcome and independent variables. Results: The research enrolled 420 pregnant and postpartum women. During the current pregnancy, 24.8% of the women used self-medication. The leading common causes/symptoms that necessitate self-medication among pregnant and postpartum women were Anemia (84.8%), epigastralgia (16.8%), vomiting, pyrosis (15.2%), and urinary and vaginal infections The therapeutic families concerned with self-medication practice were Analgesics (41.4%), Antacids (20.3%), antimicrobials (13.5%), and Vitamin supplements (9%). According to the findings, the most frequent sources of information were pharmacists (45.6%), followed by physicians (44.3%). The primary reasons given by respondents for self-medication were the need for rapid release (51.7%), previous treatments with the same drugs (31.7%), and 20% reported difficulty of access to healthcare professionals. Out of 95.9% of the participants reported that they knew the dangers of self-medication and 96% of them were informed and received information about the dangers and contraindications of self-medication during pregnancy. This was significantly statistically associated with self-medication respectively with p-value = 0.031 and p-value = 0.005. Conclusion: The findings of the present study provide an initial awareness of the state of self-medication among pregnant and postpartum women attending the regional hospital centers. It is recommended that healthcare professionals increase their interventions to improve the consciousness of pregnant women; this might require implementing suitable strategies to regulate the commercialization, delivery, and use of conventional medications.

The impact of COVID-19 on the quality of life of southern Moroccan doctors : A gender-based approach.

OBJECTIVES: After the World Health Organisation (WHO) declared COVID-19 a global pandemic, various countries took preventive health measures to limit the spread of the coronavirus. The quality of life (QOL) of many populations was affected by lockdown and social distancing. The pandemic increased healthcare professionals' workload and decreased doctors' QOL. Our study aimed to evaluate the QOL of doctors in southern provinces of Morocco during the COVID-19 pandemic. In addition, the study compared QOL of the two genders at that time. METHODS: This was a cross-sectional and descriptive study. The sample included 257 doctors practicing in the southern provinces of Morocco. To assess QOL, we used the online self-administered WHOQOL-BREF questionnaire, which evaluates QOL in four domains: physical, mental, social and environmental. The cut-off between good and poor QOL was 60. RESULTS: All doctors showed poor QOL in all domains. The mean scores and standard deviations for the physical, mental, social, and environmental domains were 57.88 ± 17.12, 57.09 ± 20.13, 55.57 ± 23.66 and 47.99 ± 17.34, respectively. Comparing the two genders, males had a higher QOL than females with a statistically significant difference (p-value ≤ 0.05) in all domains. Both men and women had poor QOL in the environmental domain (less than 60). Doctors who worked directly in the COVID-19 circuit had poorer QOL in all domains. Even with scores lower than 60, males working in COVID-19 circuit had better QOL compared to females, except in the social domain. CONCLUSION: Southern Moroccan doctors' QOL was reduced in all domains. All doctors working in COVID-19 circuit had poor QOL, and women's scores were even lower than those of men.

Dataset to explore factors affecting COVID-19 vaccination intention. Evidence from Morocco.

The coronavirus pandemic (COVID-19) has had an immense impact on humanity in every aspect of life. Governments around the world have mandated movement restrictions, including in the Moroccan government, in which unfortunately the pandemic continues to propagate and causes serious problems for public health and economic activities in the Kingdom. As a major factor in the fight against the spread of COVID-19, the Moroccan government has undertaken major efforts to ensure the availability of the COVID-19 vaccines for all citizens. These valuable efforts resulted in initiation of the vaccination campaign, which started on February 14, 2021. As vaccination was voluntary, identifying the factors promoting citizen's intention to take the vaccine against COVID-19 may help government to take additional precautions to address the propagation of COVID-19, and ensure a return to normal life. Hence, this data article aims to identify factors influencing the Moroccan citizens to get a vaccine for COVID-19. The data were collected using an online questionnaire among Moroccan citizens. In addition, the Partial Least Squares Structural Equation Modeling technique was adopted in order to analyze the collected dataset.

Association of Prostate Cancer with Nuts, Seeds, Alcohol and Processed Meats: A Worldwide Population-Based Study.

There are conflicting data with regards to the link between diet and the prostate cancer. The purpose of this study was to assess the association of dietary factors with incidence, prevalence and mortality rates of prostate cancer worldwide. We conducted an ecological study including 170 countries, whose data on incidence, prevalence and mortality rates of prostate cancer, dietary factors, and potentially confounding factors were available and collected in May 2020. Univariable and multivariable linear regression analyses were used. Consumption of nuts and seeds was inversely associated with incidence, prevalence and mortality rates of prostate cancer (ß -0.7, P < 0.001; ß -2.1, P < 0.001; ß -0.1, P = 0.02; respectively). Intake of alcohol was associated with increased incidence, prevalence and mortality rates of prostate cancer (ß 1.8, P < 0.001; ß 4.5, P < 0.001; ß 0.4, P < 0.001; respectively). Consumption of processed meats was also associated with increased incidence and prevalence rates of prostate cancer (ß 0.6, P = 0.003; ß 2.8, P = 0.001; respectively). These data suggest that consumption of nuts and seeds have a protective effect against prostate carcinogenesis, progression, and metastasis, while alcohol and processed meat increase these risks.

Association of Processed Meats and Alcohol Consumption with Renal Cell Carcinoma: A Worldwide Population-Based Study.

The link between diet and renal cell carcinoma (RCC) is still unclear. The purpose of this study was to evaluate the association of diet with RCC's incidence and mortality rates worldwide. We conducted an ecological study including 170 countries, whose data on age-standardized (AS) incidence and mortality rates of RCC, dietary factors, and potentially confounding factors such as obesity, insufficient physical activity, tobacco smoking, hypertension, diabetes, and human development index (HDI) were collected and available on May 2020 from the Global Cancer Observatory, the Global Dietary Database, the Global Health Observatory data repository, the Diabetes Atlas 9th edition and the Human Development Report 2019. Univariable and multivariable linear regression analyses were performed to determine the association of dietary factors with incidence and mortality rates of RCC adjusted for the effects of population age and potentially confounding factors. Intake of processed meats and consumption of alcohol were both positively associated with AS incidence rates of RCC (ß = 0.11, P < 0.001 and ß = 0.1, P = 0.044, respectively). We suggest that high consumption of processed meats and/or alcohol is a risk factor for RCC. However, they were not associated with mortality. Further research is needed at an individual level.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2020.1856388.

Food and lipid intake alters the pharmacokinetics of cyclosporine in kidney transplants.

Prevention of kidney graft rejection with cyclosporine leads to a large interindividual pharmacokinetic variability. However, food intake is likely to alter cyclosporine pharmacokinetics, and therefore its efficacy. The aim of our study was to evaluate the influence of food and lipid intake on cyclosporine pharmacokinetics. Twenty-four kidney grafted patients treated with Neoral® were included in this prospective monocentric study. In all patients, the pharmacokinetics of cyclosporine was evaluated in two occasions, after meal ('feed') and without meal ('fasting'). At each occasion, blood samples were collected at trough, and 0.5, 1, 2, 3, and 4 h after administration. Cyclosporine pharmacokinetics was described using a Bayesian pharmacokinetic model including two-compartments with first-order transfer and elimination rate constants, and a gamma absorption model. Influence of meal or olive oil, very common in Morocco, was tested as covariates on interoccasion variability parameters. Cyclosporine concentration-time data were satisfactorily described using the Bayesian pharmacokinetic model. Food intake significantly increased volume of distribution and decreased elimination of cyclosporine. The influence of oil intake explained a large part of this effect, suggesting that lipid intake was the main factor of pharmacokinetic variability due to food. This intake resulted in a decrease in area under the concentration curve between two administrations of 14.6%. Food, and especially lipid intake is likely to decrease the exposure to cyclosporine and may therefore lead to a decrease in treatment efficacy. Therefore, to ensure optimal immunosuppression in time, meal composition should remain as steady as possible.

Pharmaco-Analytical Study and Phytochemical Profile of Hydroethanolic Extract of Algerian Prickly Pear (Opuntia ficus-indica.L).

BACKGROUND: "Opuntia ficus-indica" (prickly pear) is the cactus member of the Cactaceae family as an important nutrient and food source. OBJECTIVE: The purpose of this study was to characterize the phytochemical composition of hydroalcoholic extract of prickly pear seeds that cause therapeutic effects. METHODS: Phytochemical screening based on simple tests and determination of secondary metabolites were performed by High-Performance Liquid with Diode-Array Detection (HPLC-DAD) analysis. For the pharmacological studies, the anti-inflammatory activity in rats was evaluated by carrageenaninduced inflammation, the description of the sedative activity was carried to the following behavioural tests, and the analgesic effect of the extract was assessed by the resistance induced by acetic acid, and the tail immersion test in mice. RESULTS: The test drug at 500 mg/kg dose showed a significant increase in mean latency in the TAIL FLICK test, and a decrease in the average number of twisting movements in the KOSTER test, thus, a significant anti-inflammatory activity in the pattern of paw edema induced by carrageenan, and an important sedative effect on the central nervous system. CONCLUSION: These data suggest that the seeds of the cactus "Opuntia ficus-indica" could be a potential source of natural compound and reveal that the hydroethanolic extract of this species is a promising source, as well as a therapeutic agent for the research of new natural active ingredients.

[Pharmacogenetics and prediction of side effects of drugs]. / Pharmacogénétique et prédiction des effets indésirables des médicaments.

Drug response is often variable from one individual to another, which sometimes makes them difficult to use when the therapeutic range is narrow. This interindividual variability in response can be explained in part by genetic factors affecting the metabolism, transport and the mechanism of action of drugs. Pharmacogenetics studies the genetic mechanisms involved in the response to drugs in order to optimize drug therapy, both in terms of efficacy and job security. This article summarizes the most known present clinical applications that illustrate the benefit of pharmacogenetic tests available to the clinician and are feasible for routine therapeutic management of patients (prediction of efficacy and toxicity of drugs), but also to demonstrate the benefit of pharmacogenetic tests in terms of health economics (reducing the incidence of hospitalizations for adverse drug events).

[Customizing dosage drugs what contribution in therapeutic drug monitoring?]. / Personnalisation posologique des médicaments Quel apport du suivi thérapeutique pharmacologique ?

Drug response is often variable from an individual to another: the same dose of drug administered to different patients could cause variable pharmacological effects in nature and intensity. Those effects are often the result of variability in drugs pharmacokinetics (absorption, distribution, metabolism and elimination) which alter their bioavailability. In fact, two factors should be taken into account: the disease(s) from which the patient suffers, and the associated drugs, because many drug interactions may alter their pharmacokinetics causing consequently quite enough of different therapeutic effects. The choice of the assay of the drug subject in monitoring is crucial, it allows quantifying the in vivo dose of the drug and the quality of compliance thereof, the pharmacokinetic characteristics allows the clinician to adjust the dosage by different approaches so that plasma concentrations are included in the therapeutic range. Therapeutic monitoring aims to increase clinical efficacy and to minimize toxicity.

Pituitary mass induced by pharmacological interaction.

A pituitary mass secondary to peripheral hypothyroidism drug interaction is rare. Very few cases are reported in the literature. Neglecting this pathological association that is not initially obvious, might lead to very invasive surgical treatment, while the pathology could have a very good outcome using medical treatment. The goal of this paper is to illustrate the importance of pharmacovigilance in patients suspected with hypothyroidism induced by drug interaction. We report a 41-year-old women presenting a pituitary mass secondary to hypothyroidism originated from L-thyroxine malabsorption induced by interaction with calcium. The patient underwent dose reduction of L-thyroxine and calcium, and the new therapy protocol included a 3 hour interval between L-thyroxine and calcium administration. The results consisted of important regression of the clinical, biological, and imaging symptoms.

[Long-term malaria prophylaxis with mefloquine: a study of adverse drug reactions]. / Chimioprophylaxie de longue durée à la méfloquine : étude des effets indésirables.

PURPOSE: To estimate the relative frequency of reported adverse drug reactions during the malaria chemoprophylactic period of the Moroccan contingent in Democratic Republic of Congo (DRC). METHODS: The transversal survey involved all military personnel of the Moroccan contingent and was carried out using a questionnaire to be filled out by a multidisciplinary medical team. It was performed in all the military sites and the advanced posts accessible during the period of the study. RESULTS: The study involved 362 male military subjects. Ninety-four adverse drug reactions were described: neuropsychiatric (anxiety, irritability, dizziness...) [n=76], digestive (anorexia, diarrhea, nausea...) [n=42], cardiovascular (tachycardia, palpitation, precordialgia...) [n=5], musculoskeletal (arthralgia, cramps) [n=4], cutaneous (redness, purpura) [n=2], and other (n=13). No "unexpected" or "serious" adverse drug reaction was reported. The causality assessment score was determined in 94 cases. Two of these reports were rated "likely", 12 "possible" and 80 doubtful. More adverse drug reactions were reported by subjects having medical and paramedical functions. CONCLUSION: During our study, mefloquine induced adverse drug reactions in a quarter of the treated subjects. Most of the adverse drug reactions were neuropsychiatric. No "serious" adverse drug reactions were reported underlying the interest of its use, even for long-term chemoprophylaxis.