[A e-Hypercalcemia]. / À propos d'une e-Hypercalcémie.

INTRODUCTION: Hypercalcemia is a common biological abnormality. The etiologies are mainly represented by hyperparathyroidism and neoplastic causes. The other causes, including poisoning, are rare, but should not be neglected. OBSERVATION: An 82-year-old female patient presented to the emergency room for repeated falls at home, confusion, drowsiness and digestive symptoms. The initial assessment showed hypercalcemia above 3mmol/L. The etiological exploration revealed a very high concentration of 25OH-vitamin D. After repeated interrogations, it appeared that the cause of this intoxication was the intake of a food supplement purchased on the internet, following a prescription from her dentist. CONCLUSION: Intoxication due to a food supplement containing vitamin D is possible and potentially serious. Raising the awareness of patients and healthcare professionals is necessary in order to prevent this type of poisoning and/or to diagnose it as soon as possible.

How does the general population approach their pain? A cross-sectional study in Palestine.

Background: Pain perception and management vary across cultural contexts; yet, little is known about pain approaches in the general population of Palestine. Existing research lacks specific knowledge about how pain is coped with in this region. Objective: To explore pain management among Palestine's general population, studying prevalence, characteristics, and sociodemographic influences. It aims to uncover treatment choices and understand cultural impacts on pain experiences, offering insights into Palestinian pain perception and coping strategies. Methods: Convenience and snowball sampling methods were employed to collect data from 646 adults in Palestine. Participants' sociodemographic characteristics, pain experiences, and pain management strategies were examined. Descriptive statistics, chi-square tests, and binary logistic regression followed by multiple logistic regressions were used for data analysis. Results: A significant portion of participants reported experiencing pain, with chronic pain being predominant. Pain prevalence varied across age groups, with higher rates in the elderly, followed by middle-aged and younger participants. Marital status and education level were linked to pain prevalence. Participants employed diverse pain management strategies, such as self-medication, physician visits, complementary medicine, and physical therapy. Age, gender, marital status, and education level influenced choices in pain management approaches. For instance, the elderly favored traditional medical interventions, while higher education levels were associated with reduced inclination toward conventional treatments. Conclusion: This study underscores the complex interaction of sociodemographic factors, pain experiences, and treatment preferences in pain management. It emphasizes personalized strategies considering age, marital status, education, and gender. Integrating these aspects improves treatment and satisfaction. The findings empower healthcare providers to create precise strategies, enhancing patient experiences for better outcomes.

Evaluation of the Needs and Experiences of Patients with Hypertriglyceridemia: Social Media Listening Infosurveillance Study.

BACKGROUND: Hypertriglyceridemia is a risk factor for cardiovascular diseases. Internet usage in China is increasing, giving rise to large-scale data sources, especially to access, disseminate, and discuss medical information. Social media listening (SML) is a new approach to analyze and monitor online discussions related to various health-related topics in diverse diseases, which can generate insights into users' experiences and expectations. However, to date, no studies have evaluated the utility of SML to understand patients' cognizance and expectations pertaining to the management of hypertriglyceridemia. OBJECTIVE: The aim of this study was to utilize SML to explore the disease cognition level of patients with hypertriglyceridemia, choice of intervention measures, and the status quo of online consultations and question-and-answer (Q&A) search platforms. METHODS: An infosurveillance study was conducted wherein a disease-specific comprehensive search was performed between 2004 and 2020 in Q&A search and online consultation platforms. Predefined single and combined keywords related to hypertriglyceridemia were used in the search, including disease, symptoms, diagnosis, and treatment indicators; lifestyle interventions; and therapeutic agents. The search output was aggregated using an aggregator tool and evaluated. RESULTS: Disease-specific consultation data (n=69,845) and corresponding response data (n=111,763) were analyzed from 20 data sources (6 Q&A search platforms and 14 online consultation platforms). Doctors from inland areas had relatively high voice volumes and appear to exert a substantial influence on these platforms. Patients with hypertriglyceridemia engaging on the internet have an average level of cognition about the disease and its intervention measures. However, a strong demand for the concept of the disease and "how to treat it" was observed. More emphasis on the persistence of the disease and the safety of medications was observed. Young patients have a lower willingness for drug interventions, whereas patients with severe hypertriglyceridemia have a clearer intention to use drug intervention and few patients have a strong willingness for the use of traditional Chinese medicine. CONCLUSIONS: Findings from this disease-specific SML study revealed that patients with hypertriglyceridemia in China actively seek information from both online Q&A search and consultation platforms. However, the integrity of internet doctors' suggestions on lifestyle interventions and the accuracy of drug intervention recommendations still need to be improved. Further, a combined prospective qualitative study with SML is required for added rigor and confirmation of the relevance of the findings.

Topic and Trend Analysis of Weibo Discussions About COVID-19 Medications Before and After China's Exit from the Zero-COVID Policy: Retrospective Infoveillance Study.

BACKGROUND: After 3 years of its zero-COVID policy, China lifted its stringent pandemic control measures with the announcement of the 10 new measures on December 7, 2022. Existing estimates suggest 90%-97% of the total population was infected during December. This change created a massive demand for COVID-19 medications and treatments, either modern medicines or traditional Chinese medicine (TCM). OBJECTIVE: This study aimed to explore (1) how China's exit from the zero-COVID policy impacted media and the public's attention to COVID-19 medications; (2) how social COVID-19 medication discussions were related to existing model estimates of daily cases during that period; (3) what the diversified themes and topics were and how they changed and developed from November 1 to December 31, 2022; and (4) which topics about COVID-19 medications were focused on by mainstream and self-media accounts during the exit. The answers to these questions could help us better understand the consequences of exit strategies and explore the utilities of Sina Weibo data for future infoveillance studies. METHODS: Using a scrapper for data retrieval and the structural topic modeling (STM) algorithm for analysis, this study built 3 topic models (all data, before a policy change, and after a policy change) of relevant discussions on the Chinese social media platform Weibo. We compared topic distributions against existing estimates of daily cases and between models before and after the change. We also compared proportions of weibos published by mainstream versus self-media accounts over time on different topics. RESULTS: We found that Weibo discussions shifted sharply from concerns of social risks (case tracking, governmental regulations, etc) to those of personal risks (symptoms, purchases, etc) surrounding COVID-19 infection after the exit from the zero-COVID policy. Weibo topics of "symptom sharing" and "purchase and shortage" of modern medicines correlated more strongly with existing susceptible-exposed-infected-recovered (SEIR) model estimates compared to "TCM formulae" and other topics. During the exit, mainstream accounts showed efforts to specifically engage in topics related to worldwide pandemic control policy comparison and regulations about import and reimbursement of medications. CONCLUSIONS: The exit from the zero-COVID policy in China was accompanied by a sudden increase in social media discussions about COVID-19 medications, the demand for which substantially increased after the exit. A large proportion of Weibo discussions were emotional and expressed increased risk concerns over medication shortage, unavailability, and delay in delivery. Topic keywords showed that self-medication was sometimes practiced alone or with unprofessional help from others, while mainstream accounts also tried to provide certain medication instructions. Of the 16 topics identified in all 3 STM models, only "symptom sharing" and "purchase and shortage" showed a considerable correlation with SEIR model estimates of daily cases. Future studies could consider topic exploration before conducting predictive infoveillance analysis, even with narrowly defined search criteria with Weibo data.

Usage of Natural Health Products (NHPs) for respiratory diseases: user characteristics and NHP-Consumption behavior during the Covid-19 pandemic in Germany.

BACKGROUND: Respiratory diseases (RD) can challenge healthcare systems around the globe. Natural health products (NHPs) are popular complementary and alternative medicine options for health issues concerning non-fatal RD. Little is known about the characteristics of the users of RD-NHPs and about their NHP consumption behavior during the Covid-19 pandemic in Germany. METHODS: A representative online survey was conducted in Germany in 2022. 1707 participants were classified based on having used NHPs for RD within the previous 12 months, having used NHPs but not for RD within the previous 12 months and not having used NHPs. Data were analyzed using descriptive and inferential statistical methods as well as a multinomial logistic regression model. RESULTS: Users of RD-NHPs within the previous 12 months were more likely to be employed and to consult pharmacists more often for non-fatal health issues than individuals who did not take RD-NHPs. RD-NHP users were more likely to suffer from a Covid-19 infection and to have children living in the same household than other NHP users. Compared to non-NHP users, RD-NHP users were more likely to be female, highly educated and have stronger openness-to-change value orientations. Vaccination-related behavior was no indicator of RD-NHP usage. Most RD-NHP users took NHPs in self-medication. Few reported informing their practitioner about their self-medication. Drugstores were the most visited supply source for NHPs during the pandemic, followed by pharmacies. Common information sources regarding NHPs were the products themselves and pharmacists. CONCLUSION: This study emphasized the important role of NHPs as a popular prevention and treatment option for RD. RD-NHPs were more likely used by individuals who were employed, who suffered from a RD and who consult pharmacists for non-fatal health issues. The importance of product information and pharmacies as information sources should be considered to make communication strategies about safe self-medication options with RD-NHPs more effective, which could help to reduce the burden of health facilities regarding non-fatal RD. To improve and develop future pandemic-control strategies, health professionals and policy makers should consider NHP usage behavior and provide critical information about chances and risks of self-medicated NHP consumption.

[Evaluation of self-medication practices and their characteristics among Uvira in Democratic Republic of Congo students]. / Evaluation des pratiques de l'automédication et leurs caractéristiques auprès des étudiants d'Uvira en République Démocratique du Congo.

Introduction: self-medication poses a threat to public health. The purpose of this study was to evaluate self-medication practices among Uvira students in the Democratic Republic of the Congo (DRC). Methods: we conducted a cross-sectional descriptive study based on an indirect interview of 700 students, using a self-administered survey questionnaire. Data were processed using XLSTAT. Results: according to the survey conducted on these 700 students, the prevalence of self-medication was 99.3% (n=695), of which 42.3% (n=294) started during adolescence. Of the total respondents, 57.4% (n=399) said they resorted to self-medication every time they fell ill and were short of money (n=471, 67.7%) for a consultation. The most commonly cited pathology encountered during this practice was malaria (n=212, 30.5%). Of all drugs used, paracetamol was in the first place (n=106, 15.3%) while the tablet was the form most used by these students (n=598, 86%). In terms of the drug combination, Fansidar-Coartem (n=106, 17.2%) was the most common; the dosage was age-dependent in 65.6% (n=456) of cases. This study also showed that 37.4% (n=695) of the students interviewed used phytotherapy, mainly to treat malaria (n=124, 47.3%). Conclusion: among Uvira students, self-medication is extremely used, especially against malaria. Efforts must be made by healthcare personnel in collaboration with policymakers to raise awareness about the rational use of medications, in order to better control and potentially eradicate this practice that is harmful to health.

Consumption of food supplements in the Fes-Meknes region (Morocco); profiles and typology.

Background: The consumption of food supplements is increasing. This evolution is due to several factors, including nutritional deficiencies in the population, a sedentary lifestyle, and a decrease in physical activity. In addition, stress and an active lifestyle led to several dysfunctions (fatigue, deconcentration) that food supplements can help to overcome. Objective: This study aimed to determine the profiles of food supplement consumers in the Fes-Meknes region (Morocco), distribution, and production of these products. In addition, this survey aimed to evaluate consumers' knowledge of food supplements as part of their self-medication. Material and methods: The present study was conducted in the form of a survey using a questionnaire composed of two parts. The first part provides information on the socio-demographic status of respondents, including gender, age, and level of education. The second part concerned various information on the consumption of food supplements. Results: The results obtained showed that of the 498 subjects, 68.88% declared that they had already consumed the food supplements. The study revealed the predominance of the female gender at 69.68% and the age group 21-30 years (80.32%). Among the reasons for consumption, improving general health comes first with 56.29%. Our results also showed high consumption of vitamins (44.04%) and minerals (24.79%), next come proteins and plant extracts at 16.62% and 14.54% respectively. The consumption of food supplements is most often done on the advice of a doctor or dietician with 43.60%, and the pharmacy and para-pharmacy remains the main distribution channel at 75.78%. Conclusion: The present survey allowed us to update the current situation of food supplement consumption and a way of regulatory monitoring and more control for an organization of the sector.

Vitamin D Toxicity Masquerading as Acute Pancreatitis.

Patients and medical professionals are showing renewed interest in vitamin D supplementation as a result of increased knowledge of the positive health effects of vitamin D supplementation, the prevalence of vitamin D deficiency, and the easy availability of over-the-counter vitamin D pills. We present a case of acute pancreatitis following vitamin D toxicity due to the administration of doses exceeding the recommended dosage. A 61-year-old man presented to us with elevated pancreatic enzymes, increased 25-hydroxyvitamin D (25-OHD) levels, and deranged renal function tests. He was kept nil per oral and managed with intravenous fluids and denosumab injection. We advocate educating medical professionals about the frequently disregarded side effect of vitamin D supplementation. At the same time, it is critical to create awareness among the public about the harmful effects of self-medication.

Factors associated with the incidence and the expenditure of self-medication among middle-aged and older adults in China: A cross-sectional study.

Background: With the accelerated ageing of population and the growing prevalence of various chronic diseases in China, self-medication plays an increasingly important role in complementing the health care system due to its convenience and economy. Objective: This study aimed to investigate the incidence of self-medication and the amount of self-medication expenditure among middle-aged and older adults in China, and to explore factors associated with them. Methods: A total of 10,841 respondents aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS) wave 4 which conducted in 2018 were included as the sample of this study. The two-part model was adopted to identify the association between the incidence of self-medication and the amount of self-medication expenditure and specific factors, respectively. Results: The incidence of self-medication among Chinese middle-aged and older adults was 62.30%, and the average total and out-of-pocket (OOP) pharmaceutical expenditure of self-medication of the self-medicated individuals were 290.50 and 264.38 Chinese yuan (CNY) respectively. Participants who took traditional Chinese medicine (TCM), self-reported fair, and poor health status, suffered from one and multiple chronic diseases had strongly higher incidence of self-medication. Older age and multiple chronic diseases were strongly associated with higher expenditure of self-medication. Those who took TCM had more self-medication expenditure, while those who drank alcohol had less. Conclusion: Our study demonstrated the great prevalence of self-medication among middle-aged and older adults in China and the large pharmaceutical expenditure that come with it, especially in the high-risk groups of self-medication identified in this paper. These findings enhanced our understanding of self-medication behaviors among Chinese middle-aged and older adults and may contribute to the formulation of targeted public health policy.

Using 17th century medication for modern diabetes management: Doctors' perceptions of self-medication practices - A qualitative study.

Purpose: This study was conducted to explore doctors' perceptions and understanding of the self-medication practices of people living with type 2 diabetes. Methods: A qualitative research design incorporating 20 semi-structured, face-to-face interviews were conducted with doctors treating people with type 2 diabetes in Mysuru, India, between July 2019 and January 2020. All the interviews were conducted in doctors' clinics, audio-recorded and thematically analyzed. Results: Three themes were identified from these interviews- i) Doctors' beliefs towards their patients' use of traditional medicine and environmental factors influencing prescription practices, ii) Doctors reported little faith in traditional medicines, iii) Limited strategies implemented by doctors to overcome barriers to self-medications. Doctors reported greater belief in western medications over traditional medications and expressed concern that their patients favored traditional medications over western. Multiple factors such as social media, accessibility of healthcare facilities and pill burden influenced adherence to western medications. Also, lack of knowledge about traditional medications and trust in western medications available under government schemes have influenced prescription practices among doctors. It appears that doctors implemented strategies such as educating patients on the detrimental effects of self-medication and insisting on patients to take only western medications to achieve desired blood glucose levels when managing self-medication practices among people with diabetes. Conclusion: These results suggest that doctors have limited strategies to implement to prevent self-medication practices among people with diabetes. Increasing knowledge amongst doctors about JAS medication effectiveness and thereby garnering greater trust in generic medications. In addition, efforts should be made to identify the best ways to integrate traditional and western medicine into patient-centered care delivery. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01154-5.

Serious Skin Injuries Following Exposure to Unapproved Mole and Skin Tag Removers.

Objective: We sought to describe skin injuries associated with unapproved topical mole and skin tag removers containing concentrated salicylic acid, Sanguinaria canadensis, or other caustic agents. Methods: We identified skin injuries associated with unapproved non-device topical mole and skin tag removers reported to the US Food and Drug Administration (FDA) through October 30, 2021 or described in Amazon consumer product reviews between 2019 and 2021. Results: We identified 38 cases, including 30 from Amazon consumer product reviews and eight reported to the FDA. Twenty-eight were from 2021. The most common reason for use was for mole and/or skin tag removal. Listed ingredients included salicylic acid, Sanguinaria canadensis, botanicals (includes homeopathic products), and calcium oxide. Seven cases involved products without ingredients listed. Adverse events included burns, pain, and ulceration, some resulting in permanent scarring and disfigurement. There were 14 facial injuries, including four adjacent to the eye. Reported treatments included antibiotics, hospital care, wound care, and dermatology advice to have a skin graft. Limitations: Limitations include underreporting of adverse events to the FDA, limited clinical details and potential bias in consumer reviews, and poor replicability of review searches due to the dynamic nature of the Amazon website. Conclusion: Unapproved, non-device topical mole and skin tag removers are associated with serious skin injuries. We found Amazon consumer reviews to be a novel and useful data source for safety surveillance of these types of skin products. When dermatologists are consulted about skin injuries, exposure to these products should be considered in the differential diagnosis.

Homo medicus: The transition to meat eating increased pathogen pressure and the use of pharmacological plants in Homo.

The human lineage transitioned to a more carnivorous niche 2.6 mya and evolved a large body size and slower life history, which likely increased zoonotic pathogen pressure. Evidence for this increase includes increased zoonotic infections in modern hunter-gatherers and bushmeat hunters, exceptionally low stomach pH compared to other primates, and divergence in immune-related genes. These all point to change, and probably intensification, in the infectious disease environment of Homo compared to earlier hominins and other apes. At the same time, the brain, an organ in which immune responses are constrained, began to triple in size. We propose that the combination of increased zoonotic pathogen pressure and the challenges of defending a large brain and body from pathogens in a long-lived mammal, selected for intensification of the plant-based self-medication strategies already in place in apes and other primates. In support, there is evidence of medicinal plant use by hominins in the middle Paleolithic, and all cultures today have sophisticated, plant-based medical systems, add spices to food, and regularly consume psychoactive plant substances that are harmful to helminths and other pathogens. We propose that the computational challenges of discovering effective plant-based treatments, the consequent ability to consume more energy-rich animal foods, and the reduced reliance on energetically-costly immune responses helped select for increased cognitive abilities and unique exchange relationships in Homo. In the story of human evolution, which has long emphasized hunting skills, medical skills had an equal role to play.

Patients' Experiences With Therapeutic Approaches for Post-COVID Syndrome: Results of a Crowdsourced Research Survey.

Some patients develop multiple protracted sequelae after infection with SARS-CoV-2, collectively known as post-COVID syndrome or long COVID. To date, there is no evidence showing benefit of specific therapies for this condition, and patients likely resort to self-initiated therapies. We aimed to obtain information about therapies used by and needs of this population via inductive crowdsourcing research. Patients completed an online questionnaire about their symptoms and experiences with therapeutic approaches. Responses of 499 participants suggested few approaches (eg, mind-body medicine, respiratory therapy) had positive effects and showed a great need for patient-centered communication (eg, more recognition of this syndrome). Our findings can help design clinical studies and underscore the importance of the holistic approach to care provided by family medicine.

Therapeutic Itineraries during the Ebola Epidemic in the Democratic Republic of Congo.

While treating a disease, patients or their relatives make decisions to pursue different therapeutic options, and various stages are involved in searching for a cure. This paper explored the pattern of health-seeking in the Democratic Republic of Congo (DRC) during the 10th Ebola virus disease (EVD) outbreak. Eight hundred randomly selected adults were surveyed using a questionnaire. Qualitative data were also collected through in-depth interviews with 17 community leaders and 20 focus group discussions with community members. The results showed that modern healthcare facilities are not usually considered the first option for treatment. The therapeutic journey generally begins with the patients, who treat themselves based on the what they know about the disease and the resources they have at their disposal. However, if the disease is not cured through self-medication, then patients or their relatives will visit a pharmacy. Patients request medication they know to be effective in treating the disease, and relatives can also assist in obtaining medication in the case of immobile patients. Pharmacies commonly sell the medication to patients or their relatives without a medical prescription.

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.

Self-medication dilemma in dengue fever.

This paper focuses on the trends of self-medication practices in treating symptoms that may lead to fatal complications in dengue. As dengue is a viral infection with increasing incidence, decision regarding its treatment is mostly affected by public health believes and practices to self-treat the condition by different home remedies, over-the-counter (OTC) drugs or using outdated prescription drugs that proved beneficial in the past experience. Poverty, lack of education, and poor access to health facilities pave the way for making such decisions. Future complications can be averted by raising awareness, counseling the patients and dispensing of pharmaceuticals with strict monitoring.

Factors Associated with Self-Medication during the COVID-19 Pandemic: A Cross-Sectional Study in Pakistan.

Self-medication (SM) is characterized by the procurement and use of medicines by bypassing primary healthcare services and without consulting a physician, usually to manage acute symptoms of self-diagnosed illnesses. Due to the limited availability of primary healthcare services and the anxiety associated with the COVID-19 pandemic, the compulsion to SM by the public has increased considerably. The study aimed to assess the characteristics, practices, and associated factors of SM by the public during the COVID-19 pandemic in Sargodha, Pakistan. χ2-tests and univariable analyses were conducted to explore the identification of characteristics and the potential contributing factors for SM during COVID-19, while multivariable logistic regression models were run to study the effect of variables that maintained a significant association. The study was performed during July−September 2021, with n = 460 questionnaires returned overall (response rate: 99.5%). The majority of respondents were males (58.7%, n = 270) who live in the periphery of the town (63.9%, n = 294), and most of the respondents belonged to the age group of 18−28 years (73.3%, n = 339). A large number, 46.1% (n = 212), of the participants were tested for COVID-19 during the pandemic, and among them, 34.3% (n = 158) practiced SM during the pandemic; the most common source of obtaining medicines was requesting them directly from a pharmacy (25.0%; n = 127). The chances of practicing SM for medical health professionals were 1.482 (p-value = 0.046) times greater than for non-medical health personnel. The likelihood of practicing SM in participants whose COVID-19 test was positive was 7.688 (p-value < 0.001) times more than who did not test for COVID-19. Allopathic medicines, acetaminophen (23.6%), azithromycin (14,9%), and cough syrups (13%), and over the counter (OTC) pharmaceuticals, vitamin oral supplements, such as Vitamin C (39.1%), folic acid (23.5%), and calcium (22.6%), were the most commonly consumed medicines and supplements, respectively; being a healthcare professional or having a COVID-test prior showed a significant association with the usage of Vitamin C (p < 0.05 in all cases). Respondents who mentioned unavailability of the physician and difficulty in travelling/reaching healthcare professionals were found 2.062-times (p-value = 0.004) and 1.862-times (p-value = 0.021) more likely to practice SM, respectively; SM due to fear of COVID was more common in individuals who had received COVID-tests prior (p = 0.004). Practices of SM were observed at alarming levels among our participants. Consciousness and understanding about the possible adverse effects of SM must be established and validated on a continuous level; in addition, on a commercial level, collaboration from pharmacists not to sell products (especially prescription-only medicines) without a certified prescription must be developed and implemented.

A cross-sectional survey of self-medication with Traditional Chinese Medicine for treatment and prevention of COVID-19.

OBJECTIVE: To investigate user behavioural profiles and the prevalence of self-medication with traditional Chinese medicine (TCM) for COVID-19 among the general public in China. DESIGN: Cross-sectional study. SETTING: Self-administered online survey was carried out between January and June 2021 in China. RESULTS: A total of 1132 complete responses were received from a nationwide sample. A considerable proportion viewed TCM to be more effective than Western medicine for treating COVID-19 (67.1 %) and stated that it is safer to use TCM (63.5 %) and easier to access TCM for treating COVID-19 (63.5 %). A total of 16.4 % (95 %CI 14.3-18.7) reported ever self-medicating with TCM to resolve COVID-19 symptoms and 12.2 % (95 % CI 10.3-14.2) ever using TCM to prevent SARS-CoV-2 infection. Lianhua Qingwen capsule/granule (53.2 %), Ganmao granule (50.5 %) and Banlangen granule (44.6 %) were most commonly used to resolve COVID-19 symptoms whereas Banlangen granule (60.1 %) was commonly used for the prevention of SARS-CoV-2 infection. Older age participants, from rural areas, with chronic diseases, higher socioeconomic status, and a positive attitude towards TCM were more likely to self-medicate using TCM to resolve COVID-19 symptoms. CONCLUSION: Self-medication with TCM during the COVID-19 pandemic for symptom control or prevention is prevalent. The findings of the user behavioural profile and types of TMCs commonly used in this study provide beneficial information for the development of strategies to improve public health-seeking behaviour and the performance of the country's healthcare system in the era of the COVID-19 pandemic.

Self-Medication with Modern and Complementary Alternative Medicines in Patients with Chronic Pain.

Objective: The study aimed to assess the prevalence, pattern, and determinants of the self-medication practices with modern and/or complementary and alternative medicine (CAM) therapies in patients with chronic pain. Methods: The descriptive cross-sectional study was conducted between August 2021 and January 2022 and assessed a representative sample of chronic pain patients visiting outpatient departments in India by administering a semi-structured questionnaire. The survey questionnaire consisted of forty multiple response items, including ten questions that assessed the subjects' sociodemographic profile, for example, age, sex, education, marital status, employment status, residence, and distance of home from any health care facility. The next part of the questionnaire evaluated the practice and determinants of self-medication for chronic pain with modern or CAM therapies. It included thirty questions assessing the reasons, duration, sources of information, procurement methods, preference for a particular system of medicine, knowledge about risks or drug interactions, rationality, perception of the subject, and communication with the physician, among other aspects of self-medication for pain. Findings: Out of the 325 respondents with chronic pain, those who practiced self-medication (237) were significantly more in number than those who did not (P < 0.05). Among those who self-medicated, the practice was significantly higher in urban participants living closer to healthcare facilities, with better economic backgrounds and higher education (P < 0.05). Modern medicine was the predominant choice of self-treatment for chronic pain compared to various CAM therapies (P < 0.05). Among the alternatives, homeopathic and ayurvedic systems of medicines were preferred. The main reasons for self-medicating were urgency, ease, previous prescriptions, and presumed mildness of the underlying disease. More than one-third of the respondents opined in favor of continuing self-medication in the future. Conclusion: The prevalent practice of self-medication for chronic pain may not be hazardous, but it can turn into a serious problem if not based on correct information. The inherent risks need to be minimized by increasing awareness, health education, and pharmacy regulations.

Self-medication among pregnant women in Ghana: A systematic review and meta-analysis.

Background: Despite the associated health risks of self-medication during pregnancy, recent evidence suggests that the phenomena persist in most countries. However, self-medication during pregnancy in Ghana is poorly understood due to the lack of a comprehensive review study. Objectives: We sought to review existing literature on the prevalence of self-medication, drugs used in self-medication, diseases associated with self-medication, and why pregnant women in Ghana self-medicate. Methods: A comprehensive search was conducted in PubMed, Science Direct, African Journal Online (AJOL), Google Scholar, and the websites of Ghanaian universities to identify studies that were published until February 2022. We performed this review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A random-effects meta-analysis was done in StatsDirect statistical software and OpenMeta [Analyst] to estimate the prevalence of self-medication during pregnancy and was reported in a forest plot. Simple charts and tables were used to summarize evidence on drugs used in self-medication, diseases associated with self-medication, and reasons for self-medication. Results: Six (6) studies met our inclusion criteria and the pooled prevalence of self-medication during pregnancy was 65.4% (95% CI = 58.2%-72.6%; I 2 = 88.32%; p < 0.001). Common drugs used for self-medication included analgesics (48.1%) and herbal drugs (45.9%). Headache and lower abdominal pain were the most common conditions for which pregnant women self-medicated. The main reasons for self-medication were the perceived unserious nature of diseases, previous experience with drugs, and easy access to over-the-counter drugs. Conclusions: Self-medication among pregnant women in Ghana is substantially high. Measures need to be implemented to reduce the high prevalence of self-medication during pregnancy to achieve sustainable development goals on maternal health in Ghana. A limitation of this study was the small number of included studies, which calls for more studies on self-medication during pregnancy in Ghana.