An investigative study on the causes of depression and the coping strategies among clinical medical students in private universities in North Central Nigeria.

BACKGROUND: Depression is among known mental health conditions and students in schools of medicine are not immune to it. In this investigative study, 211 clinical medical students of two private universities from North-Central Nigeria were examined on depression prevalence, the contributory factors and their coping strategies. METHODS: The Patient Health Questionnaire 9 (PHQ-9), the Medical Student's Stressor Questionnaire (MSSQ) and identified coping strategies according to Coping Oriented to Problems Experienced Inventory (COPE) were instruments of data collection. RESULTS: The results were obtained by both descriptive analysis and test of association between some categorical variables. The depression prevalence amongst the participants was 159 (75.4%). Females (124 (78.0%)) were more depressed than males (35 (22.0%)). Factors identified as contributing to depression were the heavy academic workload (124 (78.5%)), insufficient family time (93 (58.1%)) and financial constraints (54 (34.0%)). The most utilized method of coping with their stress was engaging on social media (133 (84.2%)), followed by talking with relatives or friends (99 (62.7%)) and use of recreational drugs (20 (12.8%)). The findings from this study have shown that more than three-quarters of the respondents suffered from varying degrees of depression from mild, 63 (29.9%), moderate, 53 (25.1%) to severe, 43 (20.4%). CONCLUSIONS: The heavy academic workload was a major source of depression. Colleges of Medicine should take pro-active steps towards their students' mental health and academic workload should be well spaced to reduce the stress imposed by the frequency of examinations.

A cost-effectiveness analysis of the use of oral ibrexafungerp versus fluconazole for acute vulvovaginal candidiasis in the UK NHS primary care service.

BACKGROUND: Vulvovaginal Candidiasis (VVC) is a fungal infection causing inflammation of the vagina and/or the vulva. Symptoms include itching, irritation, and discharge. VVC presents commonly across primary care and, despite its mild symptoms, carries psychological burden and has a significant impact on women's quality of life. UK guidelines support treatment via oral or topical azole antifungal agents. Recent evidence attests to the superiority of novel non-azole antifungals. Thus, rigorous financial assessment of both antifungals is necessary for optimal VVC treatment allocation in UK primary care. AIM: To evaluate the cost-effectiveness of ibrexafungerp against the gold standard fluconazole as first-line treatment of VVC within the NHS. METHOD: A systematic review on the efficacy of ibrexafungerp and fluconazole in acute VVC was conducted. Cost-effectiveness analysis was initiated using health outcome data from the DOVE trial, a Phase 2 RCT. Costs in pound sterling were ascertained in monetary units, and effectiveness determined as reduced need for follow-up medication. RESULTS: An incremental cost-effectiveness ratio of £2185.74 was determined. This suggests oral ibrexafungerp being largely more costly yet slightly more effective than fluconazole, and thus has unfavourable net benefit. Two sensitivity analyses were conducted considering follow-up medication combination and market price, which provided confidence in the calculated cost-effectiveness ratio. CONCLUSION: This analysis highlights fluconazole's cost-effectiveness in current UK guidelines and favourability.