Self-medication among Basic Science Medical Students of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

INTRODUCTION: Self-medication is using drugs to treat self-diagnosed signs or symptoms of oneself or others. Being closer to pharmacology and pathology, medical students have been more prone to it. The study aimed to determine the prevalence of self-medication among basic sciences medical students in a tertiary care centre in Kathmandu. METHODS: A descriptive cross-sectional study was conducted among basic science students from 15 February 2023 to 14 March 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 04122022/04). A convenience sampling method was used. Data were collected online and analysed. Point estimate at 95% confidence interval was calculated. RESULTS: Among 322 basic science medical students the prevalence of self-medication was 218 (67.70%) (64.81-70.59 at 95% Confidence Interval). Fever was the most common condition treated by self-medication 106 (48.62%) and paracetamol was the most common medication 93 (42.66%). Of those who engaged in self-medication, 97 (44.50%) did so to save time. Moreover, within this group, 67 (30.73%) experienced adverse drug reactions, leading 37 (16.97%) of these students to visit a private doctor. Additionally, 138 (63.30%) refrained from prescribing medication to their family and friends. CONCLUSIONS: Self-medication among basic science medical students was found to be lower in comparison to other studies done in similar settings.

Navigating the Role of Smartwatches in Cardiac Fitness Monitoring: Insights From Physicians and the Evolving Landscape.

Alongside the advancement of technology, wearable devices like smartwatches have widely been used for monitoring heartbeat, SpO2, EKG, and pacemaker activity. However, the global question is- can they be as effective as our standard diagnostic tests- electrocardiogram and echocardiography? Reported in the studies, smartwatches to the gold standard Holter monitoring for recognizing irregular pulse showed good sensitivity (98.2%), specificity (98.1%), and accuracy (98.1%). Smartwatches can be good enough for helping people get long-term monitoring of cardiac fitness and early diagnosis of atrial fibrillation but physicians shouldn't completely rely on them and perform standard investigations once the patient with symptoms visits them. We are also concerned that there must be certain rules and regulations for FDA approval of smartwatches to maintain standard criteria before they are released in the market.

Lateral medullary syndrome resulting from atrial fibrillation due to rheumatic heart disease: A case report and literature review.

Lateral medullary syndrome, resulting from cerebellar/brainstem infarction, can occur due to cardioembolic stroke from atrial fibrillation caused by rheumatic heart disease. This rare association highlights the importance of strict arrhythmia management, prophylactic anticoagulation, and timely diagnosis to prevent debilitating neurological outcomes.

Cardioprotective effects of sodium glucose cotransporter 2 inhibitor versus dipeptidyl peptidase 4 inhibitor in type 2 diabetes: A meta-analysis of comparative safety and efficacy.

Background: Sodium glucose cotransporter 2 inhibitors are recommended for the treatment of heart failure due to their cardioprotective effects, despite primarily being used as antidiabetic medications. However, the comparative profile of two antidiabetic drugs, sodium glucose cotransporter 2 inhibitors with dipeptidyl peptidase 4 inhibitor remains unclear. Study hypothesis: This study aims to compare the safety and efficacy profiles of sodium glucose cotransporter 2 inhibitors versus dipeptidyl peptidase 4 inhibitor drugs. Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and ClinicalTrials.gov using appropriate Medical Subject Headings terms from inception until February 23, 2023. The outcomes were pooled using a random-effects model for hazard ratio with a 95% confidence interval. A p-value of <0.05 was considered statistically significant. Results: Twelve studies were included after systematic screening, with a sample size of 745,688 for sodium glucose cotransporter 2 inhibitors and 769,386 for dipeptidyl peptidase 4 inhibitor. The mean age in each group was 61.1 (8.52) and 61.28 (9.25) years, respectively. Upon pooling the included articles with sodium glucose cotransporter 2 inhibitors versus dipeptidyl peptidase 4 inhibitor, the primary outcome of all-cause death demonstrated an hazard ratio of 0.64 (0.57, 0.70), I 2: 65.54%, p < 0.001, and major adverse cardiovascular events yielded an hazard ratio of 0.76 (0.65, 0.86), I 2: 87.83%, p < 0.001. The secondary outcomes included myocardial infarction with an hazard ratio of 0.84 (0.78, 0.90), I 2: 47.64%, p < 0.001, stroke with an hazard ratio of 0.81 (0.75, 0.87), I 2: 36.78%, p < 0.001, and hospitalization with an hazard ratio of 0.62 (0.53, 0.70), I 2: 83.32%, p < 0.001. Conclusion: Our findings suggest that compared to dipeptidyl peptidase 4 inhibitor, initiating treatment with sodium glucose cotransporter 2 inhibitors provides cardiovascular disease protection and may be considered in patients with type 2 diabetes.

Prevalence of latent tuberculosis infection in Asian nations: A systematic review and meta-analysis.

BACKGROUND: Tuberculosis (TB) is a serious public health concern around the world including Asia. TB burden is high in Asian countries and significant population harbor latent tuberculosis infection(LTBI). AIM: This systematic review and meta-analysis aims to evaluate the prevalence of LTBI in Asian countries. METHOD: We performed a systematic literature search on PubMed, Embase, and ScienceDirect to identify relevant articles published between January 1, 2005, and January 1, 2023 investigating the overall prevalence of latent TB among people of Asia. Subgroup analysis was done for Asian subregions during the study period of 2011 to 2016 and 2017 to 2023, for tuberculin skin test (TST) and interferon gamma release assay (IGRA), respectively, as well as for QuantiFERON-TB (QFT) and TSPOT TB tests. Der Simonian and Laird's random-effects model was used to pool the prevalence of LTBI found using TST and IGRA. RESULT: A total of 15 studies were included after a systematic search from standard electronic databases. The analysis showed that the prevalence of latent TB in Asia was 21% (95% confidence interval [CI]: 19%-23%) and 36% (95% CI: 12%-59%) according to IGRAs and TSTs (cut off 10 mm) results, respectively. Based on IGRA, the prevalence of latent TB was 20% (95% CI: 13%-25%) in 2011 to 2016 and 21% (95% CI: 18%-24%) in 2017 to 2023. Using QFT, the prevalence was 19% (95% CI: 17%-22%) and using TSPOT, the prevalence was 26% (95% CI: 21%-31%). According to the United Nations division of Asia, the prevalence was higher for the Southern region and least for the Western region using TST and higher in the South-Eastern region and least in the Western region using the IGRA test. CONCLUSION: Almost a quarter of the Asian population has LTBI. Its diagnosis often poses a diagnostic challenge due to the unavailability of standard test in certain areas. Given this prevalence, a mass screening program is suggested with the available standard test and public awareness along with anti-TB regimen should be considered for individuals who test positive. However, for it to be implemented effectively, we need to take the affordability, availability, and cost-effectiveness of such interventions into account.