Primary dysmenorrhea and self-care strategies among Chinese college girls: a cross-sectional study.

OBJECTIVES: To explore the prevalence of primary dysmenorrhea (PD), the characteristics of PD and self-care strategies for managing PD among Chinese college girls. DESIGN: Cross-sectional study. SETTING: Changsha, China. PARTICIPANTS: A total of 2555 college girls were recruited using multistage cluster random sampling. OUTCOME MEASURES: A self-report questionnaire was used to measure sociodemographic information, characteristics of PD and self-care strategies for managing PD. Additionally, a Visual Analogue Scale was used to measure pain severity. RESULTS: Of the 2555 girls, 1306 had experienced PD, representing a 51.1% prevalence. In addition, the prevalence rates of mild, moderate and severe pain in PD were 18.1%, 27.7% and 5.4%, respectively. The most common symptoms associated with PD were cramps (96.9%), weakness (70.0%), backache (65.1%), facial blemishes (55.3%) and irritability (55.3%). Commonly used self-care strategies for managing PD comprised reducing physical activity (94.6%), keeping warm (84.6%), communicating dysmenorrhea with friends or classmates (79.0%), drinking warm beverages (75.7%) and avoiding cold drinks and foods (74.2%). In addition, only 34.8% self-medicated with Western medicine (15.6%), traditional Chinese medicine (8.6%), or both (10.6%). Medical advice was sought by 27.4% of subjects from a Western medical doctor (10.3%), a doctor of traditional Chinese medicine (13.6%), or both (3.5%). Girls who had greater pain severity were more likely to be self-medicated (OR=7.01; 95% CI 4.50 to 10.91), use complementary therapies (OR=2.64; 95% CI 1.70 to 4.10) and seek medical advice (OR=5.93; 95% CI 3.80 to 9.24). CONCLUSIONS: PD is highly prevalent among Chinese college girls, with a high burden of symptoms. In addition, these girls are most likely to change their lifestyle, communicate dysmenorrhea with friends or mothers, use heat therapy and engage in self-talk, but less likely to self-medicate or seek medical advice for managing PD.

Characteristics of deaths associated with kratom use.

BACKGROUND: Kratom (Mitragyna speciosa Korth) use has increased in Western countries, with a rising number of associated deaths. There is growing debate about the involvement of kratom in these events. AIMS: This study details the characteristics of such fatalities and provides a 'state-of-the-art' review. METHODS: UK cases were identified from mortality registers by searching with the terms 'kratom', 'mitragynine', etc. Databases and online media were searched using these terms and 'death', 'fatal*', 'overdose', 'poisoning', etc. to identify additional cases; details were obtained from relevant officials. Case characteristics were extracted into an Excel spreadsheet, and analysed employing descriptive statistics and thematic analysis. RESULTS: Typical case characteristics (n = 156): male (80%), mean age 32.3 years, White (100%), drug abuse history (95%); reasons for use included self-medication, recreation, relaxation, bodybuilding, and avoiding positive drug tests. Mitragynine alone was identified/implicated in 23% of cases. Poly substance use was common (87%), typically controlled/recreational drugs, therapeutic drugs, and alcohol. Death cause(s) included toxic effects of kratom ± other substances; underlying health issues. CONCLUSIONS: These findings add substantially to the knowledge base on kratom-associated deaths; these need systematic, accurate recording. Kratom's safety profile remains only partially understood; toxic and fatal levels require quantification.

[Self medication with Annona muricata L. (corossol) as an anti-cancer agent in Reunion]. / Automédication par Annona muricata L. (corossol) à visée anticancéreuse à la Réunion.

INTRODUCTION: Annona muricata L. also called soursop, graviola, guanabana and sapoty (French creole) is a fruit tree growing in tropical countries. The fruits, seeds, leaves and roots are used in traditional medicine. Potential anticancer effects encourage patients to consume this product as self medication. The object of the study was to determine the prevalence of use of graviola as an anticancer agent by patients treated for a lung cancer. METHODS: Our survey took place in two thoracic oncology day cares units of the university hospital of Reunion. All the patients treated by chemotherapy and immunotherapy for lung cancer were asked the same questions in a face to face interview over a 6-month period. RESULTS: One hundred questionnaires were collected. Sixty seven patients consumed graviola. In 53.7%, graviola was consumed as an anticancer agent and 25 patients took it regularly. Most often graviola was ingested as an infusion of boiled leaves (69.5%). The supply was exclusively local. CONCLUSIONS: A quarter of patients treated by chemotherapy for a lung cancer in Reunion consume graviola regularly as self medication. The consequences of this intake, drug interactions and side effects are unknown and would be interesting to identify.

Treatment of Scabies and Pediculosis in Health Education Publications and Folk Medicine of Eastern Croatia - Slavonija, Baranja, and Western Srijem County.

Scabies and pediculosis are common parasitic infestations of the skin and hair, manifesting with intense pruritus and effectively treated with modern medications. Because of the attached social stigma linking it with poverty and poor hygiene, patients will often attempt alternative folk-based remedies before confiding in their physicians. We conducted a comprehensive bibliographical study of historic folk literature and interviewed 70 individuals experienced in everyday application of folk medicine in order to categorize available remedies and provide a modern, scientific comment on their effectiveness and dangers. Compositions containing sulfur, copper sulfate, petroleum, coal, tar, and highly alkaline soaps and washing solutions undoubtedly have scabicidal and pediculicidal properties, but they are used either in high concentrations with greater possibility of intoxication and irritation or lower concentrations with questionable therapeutic benefit. These remedies, extracted from historical-cultural frameworks, are poorly adapted to modern standards and can lead to side-effects and complications. Physicians today have to be aware of the reasons their patients seek alternative remedies and know the substances and procedures they may use in self-healing, so as to be able to provide the help that may be needed if those complications occur.

Over-the-Counter Medicines and Diabetes Care.

OBJECTIVES: People with diabetes turn to over-the-counter (OTC) medicines for many ailments. The focus of this brief review is the impact common OTC medicines might have on this group of patients. METHODS: Three types of OTC medicines were selected as most deserving of attention: 3 herbal agents, nonsteroidal anti-inflammatory drugs (NSAIDs) and cough/cold products. Existing literature was used to determine precautions that might be in order. RESULTS: Herbal/natural agents with the potential to impact blood sugar have been identified in various reports. In discussing 3, glucosamine and cinnamon (at doses recommended on commercial products) should have minimal impact on diabetic management, whereas St. John's wort is a concern involving potential drug interactions. For colds, of about 11 active ingredients, only decongestants (primarily oral) need be considered for their possible effects on blood sugar. Finally, NSAIDs (even at OTC doses) must be used with caution, given their cardiovascular, renal and gastrointestinal risks. Care guidelines do encourage patients to take ownership of their condition. Yet the ability to self-medicate safely is not a certainty. In spite of easy access and a reasonable level of safety, OTC medicines still can negatively impact a user. NSAIDs available without prescription continue to cause concern. CONCLUSIONS: Before the use of any medicine, a person must ensure it will be safe. A health-care provider can be asked for assistance, but that option may not always be employed. Package information is there to provide critical information in lieu of that, something the self-medicating patient will, it is hoped, embrace.

Uso de plantas medicinales por la comunidad boliviana en el área metropolitana de Barcelona / Uso de plantas medicinais pela comunidade boliviana na área metropolitana de Barcelona / Use of medicinal plants by the Bolivian community in the Metropolitan Region of Barcelona

Las condiciones de vida que los inmigrantes de Sudamérica encuentran en España influye en sus prácticas para el cuidado de la salud. Los objetivos de este estudio fueron documentar la etnofarmacopea de los inmigrantes bolivianos en Barcelona y comprender sus pautas de comportamiento en relación con la necesidad de atención sanitaria. Para recabar información, tanto cualitativa como cuantitativa, se utilizaron cuestionarios y listados libres, asi como entrevistas semi-estructuradas y no estructuradas. Adicionalmente, se recogieron y documentaron todas las plantas medicinales y productos citados disponibles. A partir de entrevistas con 51 informantes, se registró un total de 60 remedios vegetales (115 citas de uso), con un total de 77 usos. Es común el pluralismo medicinal: los informantes utilizaban tanto los remedios vegetales en automedicación como la consultas con médicos de familia del sistema nacional de salud español. Los remedios vegetales culturalmente más relevantes incluyen infusiones de manzanilla (Matricaria recutita L.) y de hoja de coca (Erythroxylum coca Lam.) y Mentisan©, un ungiiento mentolado. A pesar de ser una muestra relativamente pequeña, este primer estudio sobre el uso de plantas medicinales por inmigrantes en España claramente indica que la comunidad boliviana sigue siendo fiel a sus tradiciones médicas (AU)

As condicoes de vida que os imigrantes da América do Sul encontram em Espanha influencia as suas práticas de cuidados de saúdo. Os objetivos deste estudo foram documentar a etnofarmacopeia do imigrantos bolivianos em Barcelona o entender sous padroes do comportamento em rolaçáo a necessidade de cuidados de saúdo. Para rocolhor informacoes, tanto qualitativas como quantitativas, foram utilizados questionários o listas livros, o entrevistas semi-estruturadas e nao estruturadas. Alem disso, recolhoram-se o documentaram-so todas as plantas medicinais o produtos citados disponíveis. A partir de entrevistas com 51 participantes, foram registados um total de 60 romádios vegetais (115 citacoes de uso), com um total de 77 usos. O pluralismo médico e comum: os informantes tanto usam remédios a base de plantas na auto-modicaçáo como consultas com médicos de familia do sistema nacional de saúde espanhol. Osremédios a base de plantas culturalmente mais relevantes incluem infusoes do camomila (Matricaria recutita L.) o de coca (Erythroxylum coca Lam.) o Mentisan©, um unguento mentolado. A pesar de ser uma amostra relativamente pequena, este primeiro estudo sobre o uso de plantas medicinais por imigrantes em Espanha indica claramente que a comunidade boliviana permanece fiel as suas tradicoes médicas (AU)

Living conditions that South American migrant communities encounter in Spain have an influence on their health care practices. The aims of this study are both to determine Bolivian migrants' ethnopharmacopeia in Barcelona and to understand the health-seeking strategies. Questionnaires and free-listings as well as semi-structured and unstructured interviews were used to gather both quantitative and qualitative data during the field work. Moreover, all accessible medicinal plants and herbal products mentioned were both collected and documented. As a result and on the basis of interviews with 51 informants, a total of sixty herbal remedies (115 use reports) were recorded used to treat with a total of 77 uses. Medical pluralism is common: informants used both plant remedies in self—medication and consultations with family doctors of the Spanish health care system. The most culturally salient plant remedies included chamomile (Matricaria recutita L.) infusion, infusion of coca leaf (Erythroxylum coca Lam.) and Mentisan©, a mentholated ointment. Despite of a relatively small sample size, this first study on immigrant medicinal plant use in Spain clearly shows that the Bolivian community in Barcelona remains loyal to their medical traditions (AU)

Complementary and alternative medicine treatments for children with autism spectrum disorders.

There are many treatments in current use for core and associated symptoms of autism spectrum disorders (ASD). This review discusses the complementary and alternative medical (CAM) treatments commonly added to conventional interventions for children with ASD, including natural products, mind and body practices, and other biomedical treatments. The article focuses on factors associated with use of CAM, the empirical evidence for the most frequently used treatments, and how clinicians work with families who choose CAM treatments. Some treatments have been ineffective, some have unacceptable potential side effects, and others require more study in depth.

Therapeutic itinerary of severe malaria in adults admitted to a teaching hospital in Dakar, Senegal.

INTRODUCTION: Despite prevention efforts, malaria remains a public health problem. METHODOLOGY: This was a prospective study conducted between October and December 2010 that aimed to describe the therapeutic route of adults presenting with severe malaria prior to being admitted to Fann Teaching Hospital in Dakar, Senegal. RESULTS: A total of 90 patients were included. The majority of them had consulted a public or private health care facility (92%) prior to admission. First consultation occurred on average two days after the onset of the disease. Self-medication (67.4%) and traditional medicine (26.1%) were the main causes of delaying care. CONCLUSIONS: Early care and adequate management are needed to reduce malaria mortality.

Self-induction of abortion among women accessing second-trimester abortion services in the public sector, Western Cape Province, South Africa: an exploratory study.

BACKGROUND: Despite South Africa's liberal abortion law permitting abortion on request in the first trimester and under restricted conditions for second-trimester pregnancies, the practice of unsafe self-induced abortion persists. However, the prevalence of this practice, the methods used and the reasons behind it are relatively under-researched. As part of a larger study seeking to improve abortion services in the Western Cape Province, we explored reports of prior attempts to self-induce abortion among women undergoing legal second-trimester abortion. OBJECTIVES: To describe the prevalence and methods of and factors related to unsuccessful attempts at self-induction of abortion by women presenting without complications and seeking second-trimester abortion at public health facilities in the Western Cape. METHODS: In a cross-sectional study from April to August 2010, 194 consenting women undergoing second-trimester abortion were interviewed by trained fieldworkers using structured questionnaires at four public sector facilities near Cape Town. RESULTS: Thirty-four women (17.5%; 95% confidence interval 12.7 - 23.4) reported an unsuccessful attempt to self-induce abortion during the current pregnancy before going to a facility for second-trimester abortion. No factors were significantly associated with self-induction, but a relatively high proportion of this small sample were unemployed and spoke an indigenous African language at home. A readily available herbal product called Stametta was most commonly used; other methods included taking tablets bought from unlicensed providers and using other herbal remedies. No use of physical methods was reported. CONCLUSIONS: The prevalence of unsafe self-induction of abortion is relatively high in the Western Cape. Efforts to inform women in the community about the availability of free services in the public sector and to educate them about the dangers of self-induction and unsafe providers should be strengthened to help address this public health issue.

Non-superiority of Kakkonto, a Japanese herbal medicine, to a representative multiple cold medicine with respect to anti-aggravation effects on the common cold: a randomized controlled trial.

OBJECTIVE: Kakkonto, a Japanese herbal medicine, is frequently used to treat the common cold not only with a physician's prescription, but also in self-medication situations. This study aimed to examine whether Kakkonto prevents the aggravation of cold symptoms if taken at an early stage of illness compared with a well-selected Western-style multiple cold medicine. METHODS: This study was a multicenter, active drug-controlled, randomized trial. Adults 18 to 65 years of age who felt a touch of cold symptoms and visited 15 outpatient healthcare facilities within 48 hours of symptoms onset were enrolled. The participants were randomly assigned to two groups: one treated with Kakkonto (Kakkonto Extract-A, 6 g/day) (n=209) and one treated with a Western-style multiple cold medicine (Pabron Gold-A, 3.6 g/day) (n=198) for at most four days. The primary outcome of this study was the aggravation of cold, nasal, throat or bronchial symptoms, scored as moderate or severe and lasting for at least two days within five days after entry into the study. RESULTS: Among the 410 enrollees, 340 (168 in the Kakkonto group and 172 in the Pabron group) were included in the analyses. The proportion of participants whose colds were aggravated was 22.6% in the Kakkonto group and 25.0% in the Pabron group (p=0.66). The overall severity of the cold symptoms was not significantly different between the groups. No harmful adverse events occurred in either group. CONCLUSION: Kakkonto did not significantly prevent the progression of cold symptoms, even when prescribed at an early stage of the disease.

A Cases of Near-fatal Anaphylaxis: Parsley "Over-use" as an Herbal Remedy.

The use of herbal products in patients with allergic diseases is a special problem and still controversial. But, many people often use herbs to maintain good health. The patients use self-prescribed remedies as medications but do not inform their physicians about herbal use. Unfortunately, some herbal self-medications may have unexpected effects and interactions which may lead to fatal complications. In this report, we describe a female patient who suffered near-fatal anaphylaxis to parsley.

Self-medication and related health complaints among expatriate high school students in the United Arab Emirates / Automedicación y problemas de salud relacionados entre estudiantes de secundaria expatriados en los Emiratos Árabes Unidos

Background: Self-medication, often without adult guidance, has been reported to be a common practice during adolescence. Similar to other preventable health-risk behaviors initiated in early adolescence, it has become a cause for concern universally. Objectives: This study examines the prevalence of self-medication with both prescribed and nonprescribed (OTC) medications, related health complaints, sources of drugs, and sources of drug recommendation, and gender differences related to self-medication among expatriate high school students in the United Arab Emirates (UAE). Methods: A cross-sectional survey was conducted among 324 expatriate students through a validated, self-administered questionnaire and data was analyzed using SPSS 19 version. Means and proportions were calculated and Pearson Chisquare test of significance was used to analyze association among variables. Results: Majority of the participating students, almost equally distributed by gender, was aged 16 to 17 years. The period prevalence rate of selfmedication with prescribed and OTC medications were 89.2%, which did not vary with age, gender, ethnicity or parents’ educational level. The most common sources of drug and drug recommendation were community pharmacies and parents respectively. Headache and fever were the common self-medicated conditions and consequently, analgesics and antipyretics were most commonly used both in the previous two weeks and the previous year prior to the survey. A high prevalence of self-medication with antibiotics (53%) and sedative/hypnotics (27%) was also observed. A female excess emerged for certain health complaints and use of medicines except for the use of anti-allergic and herbal/homeopathic drugs. Conclusion: This is the first study to explore selfmedication practices among high school students in UAE and provides baseline data critical in creating awareness about the risks and benefits of selfmedication. Health care providers, educators and parents should be actively involved in health education strategies for inculcating responsible selfmedication practices in the adolescent population of UAE (AU)

Antecedentes: Se ha informado de la práctica común de la automedicación entre adolescentes, a menudo sin vigilancia de un adulto. Al igual que otras actitudes de riesgo iniciadas en la adolescencia temprana, esto es de preocupación universal. Objetivos: Este estudio examina la prevalencia de automedicación, tanto con medicamentos de prescripción como de medicamentos sin receta (OTC), los problemas de salud relacionados, las fuentes de medicamentos y las fuentes de recomendaciones de los medicamentos y las diferencias de géneros relacionadas con la automedicación entre estudiantes de secundaria expatriados en los Emiratos Árabes Unidos (UAE). Métodos: Se realizó un estudio transversal entre 324 estudiantes expatriados a través de un cuestionario validado auto-administrado y los datos se analizaron en un SPSS versión 19. Se calcularon las medias y las proporciones se utilizó la prueba chi-cuadrado de significancia para analizar la asociación entre variables. Resultados: La mayoría de los estudiantes participantes, distribuidos igualmente por géneros, tenia de 16 a 17 años. La prevalencia de automedicación con medicamentos de prescripción y OTC en el periodo fue del 89,2%, y no varió con la edad, género, etnia o nivel educativo de los padres. Las fuentes de medicamentos y de consejo sobre medicamentos más comunes fueron las farmacias comunitarias y los padres, respectivamente. El dolor de cabeza y la fiebre fueron las situaciones más frecuentes y, consecuentemente, los analgésicos y los antipiréticos fueron los medicamentos más usados, tanto en las dos semanas previas a la encuesta como en el año anterior. Se observó también una alta prevalencia de automedicación con antibióticos (53%) y sedantes/hipnóticos (27%). Apareció un exceso de mujeres en el uso de ciertos problema de salud y uso de medicamentos, con excepción del uso de antialérgicos y medicamentos vegetales/homeopáticos. Conclusión: Este es el primer estudio que explora las prácticas de automedicación entre estudiantes de escuela secundaria en UAE y proporciona una base crítica para aumentar el conocimiento de los riesgos y beneficios de la automedicación. Los profesionales de la salud, educadores y padres deberían envolverse activamente en las estrategias educativas para inculcar prácticas responsables de automedicación en la población adolescente de UAE (AU)

Evaluación de las necesidades de actualización de conocimientos en materia de fitoterapia de los farmacéuticos de la ciudad de Madrid / Evaluation of the needs of updating knowledge in the field of phytotherapy for the pharmacists from madrid city

El consumo de productos de plantas medicinales, para la prevención y/o tratamiento de diversos problemas de salud, ha experimentado un notable incremento en el estado español, especialmente en las farmacias. Esto es debido entre otros factores a la constatación científica de su eficacia y seguridad y a la labor profesional realizada por parte de los farmacéuticos en la recomendación de estos preparados. En este trabajo se realiza una evaluación de las necesidades de formación de los farmacéuticos en la ciudad de Madrid como base fundamental para realizar una buena dispensación de plantas medicinales, en res- puesta a la demanda de los pacientes. Respecto a estudios anteriores, los resultados obtenidos indican un incremento en la demanda de preparados de plantas medicinales por parte de los pacientes, principalmente mujeres. Asimismo se aprecia una mayor tendencia a elegir la oficina de farmacia como lugar de adquisición, al reconocer la mejor cualificación del farmacéutico en esta materia. No se observa una modificación sustancial en cuanto a la demanda por grupos terapéuticos, si bien la crisis económica parece influir en un incremento de la dispensación de plantas para el tratamiento de la ansiedad. Los farmacéuticos encuestados muestran su interés por ampliar y actualizar los conocimientos en fitoterapia mediante acciones formativas directas y próximas (AU)

The consumption of herbal products for the prevention and / or treatment of various health problems, has seen a remarkable increase in the Spanish state, especially in pharmacies, this is due among other factors to the scientific findings of its effectiveness and safety and the great effort made by pharmacists in the recommendation of these preparations. This paper assesses the training needs of pharmacists in the city of Madrid as the foundation for a good dispensing of medicinal plants, in response to patient demand. The results we get indicate an increase in the demand of natural preparations on the part of patients, ainly women. Also there is a greater tendency to choose the pharmacy as a place to buy it, recognizing that the pharmacist is more qualified in this area. We do not find a substantial change in the demand for treatment groups, but the economic crisis seems to influence in the consume of phytotherapy plant ìs for the treatment of anxiety. The pharmacists of the study show their interest in increase and update their knowledge in herbal drug with compatible courses with their professional life’s (AU)

Factores que influyen en la automedicación del personal de enfermería a nivel técnico y de estudiantes / Factors influencing self medication nursing staff and students technical level

La automedicación, es “el consumo de medicamentos, hierbas y remedios caseros por iniciativa o consejo de otra persona, sin consultar al médico”, considerada también como un fenómeno que se ha incrementado a través del tiempo, convirtiéndose en un serio problema de salud pública. En México no existen estudios o publicaciones que permitan valorar la real magnitud de esta práctica en la población. Objetivo: Conocer los factores que influyen en la automedicación del personal de enfermería a nivel técnico y estudiantes del Instituto Nacional de Neurología y Neurocirugía.

Self-medication, is “the use of drugs, herbs and home remedies or advice on the initiative of another person, without consulting a doctor”, also regarded as a phenomenon that has been increasing over time, becoming a serious public health problem. In Mexico, there are no studies or publications to assess the real magnitude of this practice in the population. Objective: Understanding the factors that influence self-medication nursing staff technical level, and students of the National Institute of Neurology and Neurosurgery.

Association of herbal cannabis use with negative psychosocial parameters in patients with fibromyalgia.

OBJECTIVE: Patients with chronic pain, including fibromyalgia (FM), may seek treatments outside of mainstream medicine. Medicinal cannabinoids are popularly advocated for pain relief but with limited evidence for efficacy in FM. The extent of use of cannabinoids in FM is unknown. METHODS: We have documented the self-reported prevalence of cannabinoid use in 457 patients with the diagnosis of FM and referred to a tertiary care pain center. We validated the diagnosis of FM and examined the associations of cannabinoid use in these patients. RESULTS: Cannabinoids were being used by 13% of all patients, of whom 80% used herbal cannabis (marijuana), 24% used prescription cannabinoids, and 3% used both herbal cannabis and prescription cannabinoids. One-third of all men used cannabinoids. Current unstable mental illness (36% versus 23%; P = 0.002), opioid drug-seeking behavior (17% versus 4%; P = 0.002), and male sex (26% versus 7%; P = 0.0002) were all associated with herbal cannabis use. There was a trend for cannabinoid users to be unemployed and receiving disability payments. The diagnosis of FM was validated in 302 patients, with 155 assigned another primary diagnosis. When the FM group was analyzed separately, significant associations were lost, but trends remained. CONCLUSION: Cannabinoids were used by 13% of patients referred with a diagnosis of FM. The association of herbal cannabis use with negative psychosocial parameters raises questions regarding the motive for this self-medication practice. Although cannabinoids may offer some therapeutic effect, caution regarding any recommendation should be exercised pending clarification of general health and psychosocial problems, especially for those self-medicating.

Monitorización por enfermería de la administración de tratamientos biológicos subcutáneos (adalimumab) en enfermedades inflamatorias crónicas / Experience of monitoring subcutaneous biological treatment (adalimumab) by nurses in chronic inflammatory diseases

No disponible

Itinerant vending of medicines inside buses in Nigeria: vending strategies, dominant themes and medicine-related information provided / Venta itinerante de medicamentos en autobuses en Nigeria: estrategias de venta, temas dominantes e información sobre medicamentos proporcionada

Objective: To determine vending strategies and marketing themes employed by itinerant bus vendors, and assess the accuracy and completeness of information provided on medicines being sold in an urban setting in Nigeria Methods: Cross-sectional study and content analysis of itinerant vending of medicines inside buses recorded with a mobile telephone on purposively selected routes in a mega city with an estimated 18 million residents in southwestern Nigeria over a 2-month period. Two coders independently assessed 192 vending episodes by 56 vendors for 147 OTC and prescription medicines. Inter-rater reliability (Gwet AC1 =0.924; p<0.0001). Results: Fourteen thousands and four hundred potential consumers encountered 192 recorded episodes of vending of medicines inside 192 buses within the study periods. Forty-four (78•5%) of the 56 vendors were females in the 30-45 years age bracket, were mostly (75%) attired in the local ‘Iro and Buba’ Ankara fabric and showed laminated identity cards (97.5%) issued by the local association for ‘marketers’ of medicines inside buses, markets, and motor parks. Of the 14400 consumers encountered inside buses during the study period, between 6.7% and 48.3% purchased the medicines promoted. Prayers against death from road traffic accidents and diseases of physical and / or meta-physical origins were the most frequently used (76•8%) ice-breaking opening statement / strategy to gain consumers’ attention. Hematinics, multi-vitamins, simple analgesic, NSAIDs and corticosteroids were the most frequently vended medicines. Consumers’ enquiries were related to dosing for children (51.8%), elderly (28.6%), and pregnancy (52.7%); and contraindications during pregnancy (8.9%). Factual medicines information such as dose, frequency, potential side effects and contra-indications were not provided in majority of vending episodes. Conclusion: Itinerant vending of medicines and the use of misleading and melodramatic themes to secure high consumer patronage appear considerable in Nigeria. Majority of the vendors did not correctly respond to consumers medicine- related enquiries, or provide detailed factual medicines information to guide appropriate use. These misleading promotional activities could potentially encourage inappropriate purchase and probable self-medication by consumers (AU)

Objetivo: Determinar las estrategias de venta y los temas de marketing empleados por los vendedores en autobuses itinerantes y evaluar la precisión y compleción de la información sobre medicamentos proporcionada durante la venta en un área urbana de Nigeria. Métodos: Estudio transversal y análisis de contenido de la venta itinerante de medicamentos en autobuses grabadas con un teléfono móvil en rutas seleccionadas a propósito en una mega-ciudad de 18 millones de habitantes en el suroeste de Nigeria durante un periodo de dos meses. Dos codificadores evaluaron independientemente 192 episodios de venta de 56 vendedores para 147 medicamentos OTC y de prescripción. Fiabilidad inter-evaluador (K de Cohen)=0.89 [IC95% 0.76- 0.92]. Resultados: 14.400 potenciales consumidores visitaron los 192 episodios grabados de venta de medicamentos en el interior de 192 autobuses en el periodo de estudio. 44 (78.5%) de los 56 vendedores eran mujeres entre los 30-45 años, estaban mayoritariamente (75%) con tejidos tradicionales ‘Iro and Buba’ Ankara y mostraban tarjetas identificativas plastificadas (97.5%) emitidas por las autoridades locales para ‘vendedores’ de medicamentos en autobuses, mercados y aparcamientos. De los 14.400 consumidores que visitaron el interior de los buses durante el periodo de estudio, el 6.7% y el 48.3% compró los medicamentos promocionados. Oraciones contra la muerte en accidentes de tráfico y enfermedades de orígenes físicos o metafísicos eran los mensajes para romper el hielo / estrategias para ganar la atención de los clientes más frecuentemente utilizados (76.8%). Los medicamentos más frecuentemente vendidos eran los hematínicos, multivitamínicos, analgésicos simples, AINE y corticoides. Las preguntas de los consumidores estaban relacionadas con las dosis para niños (51.8%), ancianos (28.6%) y embarazo (52.7%); y contraindicaciones durante el embarazo (8.9%). En la mayoría de los episodios de venta no se proporcionaba informaciones objetivas sobre los medicamentos, como dosis, frecuencia, efectos adversos potenciales y contraindicaciones. Conclusión: La venta itinerante de medicamentos y el uso de temas engañosos y melodramáticos para asegurar el elevado consumo aparecen frecuentemente en Nigeria. La mayoría de los vendedores no respondió correctamente a las preguntas sobre medicamentos de los consumidores, ni proporcionó información objetiva detallada para guiar en el uso adecuado. Estas actividades promocionales engañosas probablemente podrían animar a la compra y a la automedicación de los consumidores (AU)

Hábitos de consumo de plantas medicinales en un centro de salud de Barcelona / Habits of consumption of medicinal plants in a Elath care center in Barcelona

El objetivo de este studio fue describer los hábitos de consumo de plantas medicinales de una muestra de pacientes atendidos durante el 2007 en un Centro de Atención Primaria de Barcelona (CAP Ciutat Meridiana). Se realizó un estudio descriptivo transversal mediante una encuesta llevada a cabo por los médicos de familia y las enfermeras del grupo de trabajo. Los resultados confirman la omisión del dato de consumo en la consulta, tanto por parte de los pacientes como del equipo sanitario: un 59,6% de los entrevistados manifestó que consumía plantas medicinales y un 74,8% de los consumidores no se lo había comentado al médico o enfermera, quienes, a su vez no habían preguntado acerca del posible consumo a un 89,8% de los entrevistados. A partir del dato de que un 58% de los consumidores tomaban a la vez medicación crónica, se calculó en un 18,8% la probabilidad de aparición de interacciones entre plantas y otros medicamentos (AU)

The aim of this study was to describe the medicinal plant consumption habits of a sample of the patients who attended a social security primary health care in Barcelona (CAP od Ciutat Meridiana) along 2007. A cross-sectional descriptive study was carried out by family doctors and nurses of the workgroup. The results confirm the missing of consumption data in the medical consultation, by both patients and practitioner. On one hand, 59,6% of the interviewed patients consume medicinal plants, and 74,8% of these did not mention it to their doctor. On the other hand, 89,6% of the doctos did not ask their patients if they consumed medicinal plants. Additionally, 58% of the patients that consumed medicinal plants, also followed a chronic drug treatment at the same time, allowing as to calculate a 18,8% of potential interactions (AU)

Dispensación de preparados fitoterápicos en farmacias comunitarias de Sevilla / Dispensation of herbal products in community pharmacies in Sevilla

Los preparados a base de plantas medicinales desempeñan un papel importante en Atención Primeria de Salud. La población consciente de esta función, dirige su interés hacie el consumo de preparados fitoterápicos para la prevención y tratamiento de us enfermedades. LA transposición de la normativa europea de estos medicamentos por la AEMPS y el interés de los profesionales sanitarios por mejorar la calidad asistencial, nos dirigió a analizar la dispensación de estos fitopreparados en las farmacias comunitarias de Sevilla. Se realizó un estudio descriptivo observacional, basado en la aplicación de un cuestionario a los pacientes. Los resultados obtenidos manifiestan la necesidad de formación de los profesionales de salud en Fitoterapia, para que prevalezca la prescripción y el consejo profesional frente a la automedicación. Por otra parte, el conocimiento actualizado y la dispensación protocolizada de los preparados fitoterápicos beneficiaría a los pacientes con tratamientos asociados a otros fármacos y favorecería la detección de interacciones medicamentosas negativas (AU)

Herbal medicinal products play a major role in Primary Health Care. The population is aware of this role and is interested in the use of herbal products for the prevention and treatment of diseases. The transposition of European directive on these drugs by the Spanish Medicines Agency (AEMPS) and the interest of health professionals to improve the quality of care, led us to analyze the dispensation of herbal products in the community pharmacies of Seville. We performed a descriptive observational study, based on a questionnaire to patients. The results show the need for training health professionals in Phytotherapy, to encourage prescription and professional advice instead of self-medication. Moreover, the updating knowledge and the protocolised dispensation of herbal preparations benefit patients being already treated with other drugs, and enable the detection of adverse drug interactions (AU)

Self medication among hospitalized patients in selected secondary health facilities in South Western Nigeria / Auto-medicación entre pacientes hospitalizados en establecimientos secundarios selectos en el sur oeste de Nigeria

Practice of self-medication has not been evaluated in hospitalized patients especially in Nigerian hospitals. Objectives: To evaluate the practice of self-medication among hospitalized patients with an aim to unearth some of the reasons for, and perceptions of benefits of this type of behaviour in secondary health care facilities. Methods: This study was carried out among 197 in-patients admitted in three secondary health facilities in southwestern Nigeria using structured questionnaire. Effects of variables such as age, gender and marital status on the practice of self medication were also evaluated using the Fisher's Exact test at p<0.05 as level of significance. Results: Response rate of the study was 93.8% with 174 respondents (88.3%) perceived that the medications prescribed for them were efficacious. Almost 38% of the respondents were self-medicating, with herbal medicines (29.2%) and western medicines (37%) partly due to side effects of the prescribed medicines. Thirty one (15.7%) respondents obtained medicines for self medication through relatives and friends. Prescription medicines used for self medication constituted 7.5%. Major reasons given for self medication included habit, availability and necessity. Ninety respondents (35.7%) had been informed by health care personnel about possible side effects of the medications. Ninety six respondents (48.7%) experienced side effects with the prescribed medications and was a major reason for self medication. Seventy six respondents (79.2%) who had side effects or other secondary symptoms informed healthcare personnel in the hospital while 16 (16.7%) informed relatives and friends. There was statistically significant association between age and the action taken on whom was informed (p=0.001). Conclusions: There is need for extra vigilance from health personnel directly responsible for care of hospitalized patients to look for incidences of self-medication and patient education on the negative aspects of administering undisclosed medicines to their health care givers especially while they are hospitalized (AU)

La práctica de la auto-medicación no ha sido evaluada en los pacientes hospitalizados, especialmente en Nigeria. Objetivos: Evaluar la práctica de auto-medicación entre pacientes hospitalizados con el objetivo de desenterrar algunos motivos y percepciones del beneficio de este comportamiento en establecimientos de cuidados secundarios. Métodos: Este estudio fue realizado entre 197 pacientes hospitalizados en tres establecimientos de cuidados secundarios en el suroeste de Nigeria utilizando un cuestionario estructurado. También se evaluó, utilizando la prueba exacta de Fischer con p<0,05 como nivel de significación, el efecto sobre la práctica de auto-medicación de variables como edad, género, estado civil. Resultados: La tasa de respuesta del estudio fue del 93,8% con 174 respondentes (88,3%) que percibían que los medicamentos prescritos eran eficaces para ellos. Casi el 38% de los respondentes se auto-medicaban, el 29,2% con plantas medicinales y el 37% con medicinas occidentales, en parte debido a los efectos secundarios de los medicamentos prescritos. 31 (15,7%) de los respondentes obtenía los medicamentos para auto-medicación de sus parientes y amigos. De los medicamentos de auto-medicación, el 7,5% eran medicamentos de prescripción. Las principales razones aportadas para la auto-medicación incluían la costumbre, la disponibilidad y la necesidad. 90 respondentes (35,7%) habían sido alertados por el personal sanitario de los posibles efectos secundarios de los medicamentos. 96 (48,7%) experimentó efectos secundarios de la medicación prescrita y esta fue la principal razón para la auto-medicación. 76 (79,2%) de los que habían tenido efectos secundarios informaron al personal sanitario del hospital, mientras que 16 (16,7%) que tuvo efectos secundarios u otros síntomas secundarios informó a sus parientes y amigos. Hubo una asociación estadística entre la edad y la acción tomada sobre quien era informado (p=0,001). Concusiones: Existe una necesidad de una vigilancia extra del personal sanitario directamente responsable de los cuidados de los pacientes hospitalizados para localizar la aparición de auto-medicación y de la educación de los aspectos negativos de la administración de medicamentos no declarada a sus profesionales de la salud, especialmente mientras están hospitalizados (AU)