Dialysis prescription: Determinants and relationship with intradialytic complications and the dialysis dose. A prospective study

Introduction: Dialysis still remains the most common modality for the treatment of end stage kidney disease and it could be maneuvered to augment its dose, minimize complications and improve outcome. Dialysis prescription is a brief of how dialysis is to be given and involves adjustments in patients' characteristics, disease or dialytic procedure. This study aimed to assess the determinants of the prescribed dialysis and its relationship with intradialytic complications and the dialysis dose. Methods: A prospective study in which 1248 sessions for 232 consented participants with end stage kidney disease on maintenance hemodialysis were studied from 2017-2020. Biodata was taken, participants were examined and blood samples were taken to determine electrolytes, urea/creatinine and hematocrit. Pearson's correlation was used to determine the strength of association between dialysis dose and some variables. Results: Determinants of the prescribed dose were dialysis frequency (P<0.001), and predialysis systolic blood pressure (P<0.001) and packed cell volume (P<0.001). Dialysis sessions without significant intradialytic blood pressure changes were most likely to be completed, as sessions with intra-dialysis hypotension were most likely to be terminated. Participants dialyzed with high flux dialyzers, via an arterovenous fistula, higher blood flow and ultrafiltration rates had higher dialysis doses (P<0.001 in all instances). Conclusion: Higher dialysis doses were achieved with higher blood flow and ultrafiltration rates. Intradialytic hypotension was common with dialysis termination, higher blood flow and ultrafiltration rates. Intradialytic hypertension was common with low flux dialyzers. An optimized dialysis prescription is needed to deliver an adequate dialysis dose and minimize complications

What is the Prevalence of Use of Herbal Medicine When Compared to Prescribed Medications in Diabetic Patients at Enmore Polyclinic?

Objective:To investigative the prevalence of herbal products used among Diabetic patients of EnmorePolyclinic and correlate with socio -demographic data and to find out the various types of herbal medicines used.Methods:A cross sectional study conducted at Enmore Polyclinic from April to June, 2019. Data were collected using a preset data collectionsheet and analyzed using Microsoft Excel.Results:From a sample size of three hundred and eleven (311) participants, two hundred and thirty (230) -74.2% used herbal medicine to control Diabetes; which was used predominantly by females. East Indians usedmore herbal products. The 51 –60 years age group recorded the highest use of herbal medicine, with corilla being the most widely used herbal product was corilla.Conclusion:The Use of Herbal Medicine in the control of Diabetic patients at Enmore Polyclinic is similar to that of the United States and Dubai, but slightly higher than that of tropical Sub-Saharan Africa and Trinidad.Recommendation:Similar studies should be carried out in other areas of Guyana so as to ascertain the country’s prevalence of the use of Herbal Medicine in the control of Diabetes. Additionally, the adherence to prescribed medication should be enforced: while the effects of these herbal products should be investigated.

Why people avoid prescribed medical treatment in India?

Avoidance in seeking prescribed medical treatment can result in adverse consequences. The study was conducted to find out the reasons to avoid prescribed medical treatment and associations with various socioeconomic variables in India. Data from the National Sample Survey Organisation 71st Round on “Key Indicators of Social Consumption: Health” (January and June 2014) have been used. Variables such as place of residence, social categories, religion, and socioeconomic status have been used to study the associations with the various reasons to avoid prescribed medical treatment. Nonseriousness about the ailment was found to be the primary reason for not seeking prescribed medical treatment. Lack of availability of medical facility, long-waiting time, and financial constraints were other important reasons. Understanding the socioeconomic differentials among the reasons why people avoid prescribed medical treatment is critical in improving the effectiveness of health-care facilities in India.

Study of drug prescription pattern and adverse drug reaction monitoring in patients with hypertension and diabetes visiting outpatient department in a government tertiary care hospital in Maharashtra, India

Background: Drug utilization study is an important tool to study the clinical use of drugs and its impact on healthcare system. DUS in patients with HTN and DM is essential to observe the changing prescribing attitude of physicians with the aim to promote rational use of drugs and to minimize the adverse drug reactions.Methods: A cross sectional observational study was conducted on randomly selected patients attending medicine outpatient department in a tertiary care hospital. Drug prescription sheets of 600 patients were studied for 18 months from January 2016 to June 2017 and the prescribing pattern was analysed using the World Health Organization basic drug indicators.Results: Total 2029 drugs were prescribed to 600 patients that belonged to various classes. The average number of drugs prescribed per encounter was 3.4. Majority (61.5%) drugs were prescribed using generic names. Percentage encounters with the antibiotics and injections were 6.3 and 11.5 per cent respectively. 38% drugs were prescribed from the 20th edition of WHO Model List of Essential Medicines. PDD in the current study was found to be significantly less than WHO DDD in all drugs. All of the prescriptions in the present study conformed to WHO guidelines and majority of them with JNC VIII guidelines.Conclusions: The findings of this study are comparable to those of other studies. However, there is a scope of improvement in areas such as overdosing, prescribing more by generic names instead of brand names and from WHO Model List of Essential Medicines.

Assessment of patients’ knowledge to their dispensed medications at Port Moresby General Hospital, Papua New Guinea

@#Limited information on drug use indicates that medicines are not optimally used. Inadequate knowledge of medication uses may lead to overuse of medicines or patient non-compliance with a medicine regimen, and result in serious outcomes. The aim of this study was to assess the patients’ knowledge on dispensed medications in pharmacy at Port Moresby General Hospital (PMGH). This was a descriptive cross-sectional study utilizing a self-administered questionnaire adapted from the WHO “Guide to Good Prescribing Practical Manual”. The questionnaire sought to elicit major classes of medicines prescribed, knowledge of patients on indications, how to use the medicines, precautions and possible adverse events. A total of 130 patients from PMGH participated in this study. Although majority of patients (94.6%) knew the instructions on the use of the dispensed medicines in terms of route of administration, dosage and frequency of usage; only 74.6% of them knew the duration of medicines use. Further, 19.2% of participants did not know the indications for which their medicines were prescribed. Knowledge on adverse effects was also significantly low i.e 34.7%. Lack of understanding of warnings and precautions was rated at 42.3%. These figures may contribute to poor patient compliance and cause possible harm to the patients. The results demonstrated lack of adequate information given to patients on their prescribed medicines. It is recommended that prescribers be re-trained on the importance of giving adequate information on medications given to patients, particularly to patients with low educational background.

Quality Analysis of Compound Yinqiao and Paracetamol and Chlorphenamine Maleate Capsules / 中国药师

Objective: Combining with national drug sampling program,to evaluate the current quality situation and problems of compound Yinqiao and paracetamol and chlorphenamine maleate capsules by testing and analyzing 78 batches of samples collected from the realm of drug production and circulation all over the country in 2015.Methods: As the current standard could not control the product quality, and combined the prescribed examination with exploratory research, the method of HPLC was used to determine the contents.GC and TLC was respectively used to identify peppermint oil and study on forsythin.Near infrared spectrum database was established by near-infrared spectroscopy (NIRS), which provided the basis for rapid testing.The results of the prescribed examination and exploratory research were statistically analyzed.Results: There were significant differences in the results of the prescribed examination and exploratory research.Conclusion: The results of exploratory research show that there are many defects in the statutory standards.The product quality of different manufactures was divers, and it is necessary to guide them to improve the preparation process and the quality.More exclusive, accurate and sensitive methods should be used to comprehensively control the quality.

Rehabilitation effect analysis of self prepared wind relieving antispasmodic Decoction and psychological intervention in the treatment of sequelae of stroke / 中国生化药物杂志

Objective To study and analyze the rehabilitation effect of self prepared wind relieving antispasmodic Decoction and psychological intervention in the treatment of sequelae of stroke. Methods 100 patients with sequelae of stroke treated in our hospital from February 2015 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. Patients in the control group were given conventional treatment, given the corresponding blood pressure, blood sugar control drugs, and brain cell protective agents. On the basis of this experiment, the experimental group was given self prepared wind relieving antispasmodic decoction, and psychological intervention was carried out to strengthen communication with patients.The therapeutic effects of the two groups were compared. Results After the corresponding treatment, the effective rate of the experimental group (92.0％) was significantly higher than that of the control group (74.0％),the difference was statistically significant (P<0.05). Before treatment, there was no significant difference in the CRP levels between the two groups. After treatment, the CRP level was(3.1±0.3)μg/mL in the experimental group was significantly lower than that in the control group,the difference was statistically significant (P<0.05). Conclusion The self-made wind relief soup and psychological intervention treatment of stroke sequelae can significantly improve the rehabilitation effect of patients, to a great extent, reduce the level of CRP, with clinical significance of further promotion.

The relationship among self-efficacy, perfectionism and academic burnout in medical school students / 한국의학교육

PURPOSE: The purpose of this study was to examine the relationship among academic self-efficacy, socially-prescribed perfectionism, and academic burnout in medical school students and to determine whether academic self-efficacy had a mediating role in the relationship between perfectionism and academic burnout. METHODS: A total of 244 first-year and second-year premed medical students and first- to fourth-year medical students were enrolled in this study. As study tools, socially-prescribed perfectionism, academic self-efficacy, and academic burnout scales were utilized. For data analysis, correlation analysis, multiple regression analysis, and hierarchical multiple regression analyses were conducted. RESULTS: Academic burnout had correlation with socially-prescribed perfectionism. It had negative correlation with academic self-efficacy. Socially-prescribed perfectionism and academic self-efficacy had 54% explanatory power for academic burnout. When socially-prescribed perfectionism and academic self-efficacy were simultaneously used as input, academic self-efficacy partially mediated the relationship between socially-prescribed perfectionism and academic burnout. CONCLUSION: Socially-prescribed perfectionism had a negative effect on academic self-efficacy, ultimately triggering academic burnout. This suggests that it is important to have educational and counseling interventions to improve academic self-efficacy by relieving academic burnout of medical school students.

Comparative research between hormone replacement therapy and self-prescribed Anshen pills for menopausal syndrome / 中国生化药物杂志

Objective To observe the clinical effects of self-prescribed Anshen pills in the treatment of female patients with menopausal syndrome . Methods From August 2012 to September 2014, 100 female patients with menopausal syndrome in Tianjin Beichen District Chinese Medicine were randomly divided into control group (50 cases) and observation group (50 cases).The control group received tibolone orally, and the observation group received self-prescribed Anshen pills orally.All treated for 3 months.Modified Kupperman score, self-rating anxiety scale ( SAS) score, self-rating depression scale (SDS) score, Pittsburgh sleep quality index (PSQI) score, menopause-specific quality of life (MENQOL) score, the main clinical symptoms and hormone levels in serum were compared; the adverse reactions were recorded.Results Compared with control group post-treatment, hot flashes and perspiration, insominia improved greatly in observation group.The serum levels of luteinizing hormone ( LH ) in observation group was (28.04 ±3.37)IU/L, which was higher than (24.48 ±6.63)IU/L in control group.PSQI score in observation group was (6.57 ±1.23), which was lower than (8.18 ±1.70) in control group.The incidence of adverse reactions in observation group was 4.0%, which was lower than 18.0% in control group, and there were significant differences between two groups ( P<0.05 ) .Conclusion Self-prescribed Anshen pills is effective and safe for menopausal syndrome.

A Prospective Drug Utilization Study in Geriatric Hypertensive Patients in a Tertiary Care Hospital, Mumbai.

Introduction: The geriatric population assumes great significance in terms of both preventive and curative health care services utilized. The patho-physio-psychological changes associated with ageing make their problems unique. In the geriatric population, hypertension accounts for a huge proportion of cardiovascular and all cause mortality and morbidity. We conducted a study to describe the patterns of antihypertensive drug use in the geriatric population, compare it to the current recommendations and conduct an analysis using the WHO-INRUD drug use indicators. Methods: A prospective cross sectional drug utilization study of 100 prescriptions of hypertensive patients (as per JNC 7) of either sex and ≥60 years was undertaken as per the WHO – DUS and the STROBE guidelines. Results: Statistically significant relation was found between BP control, and addictions and CIRSG score. The 100 prescriptions contained 344 drugs, out of which, 171 were antihypertensive drugs. Three percent of antihypertensive drugs were prescribed by generic names. Seventy nine percent of antihypertensive drugs were prescribed from the ‘hospital drug schedule’. Amlodipine, Hydrochlorothiazide, Losartan and Telmisartan were prescribed to 79%, 24%, 11%, 11% respectively. The combination of ARB (Angiotensin Receptor Blocker) + Diuretic was prescribed to 36% and that of ARB + CCB (Calcium Channel Blocker) was prescribed to 21%. The PDD/DDD ratios of Carvedilol, Losartan, Furosemide and Telmisartan were 0.7, 0.8,1 and1.2, respectively. Conclusion: Creating awareness regarding the role of addiction in BP control and advocating lifestyle changes is paramount in HTN management. Overall, the principles of rational prescribing were followed. The prescription pattern observed was as per current recommendations.

In-hospital weight loss, prescribed diet and food acceptance / Perda de peso hospitalar, dieta prescrita e aceitação de alimentos

BACKGROUND: Weight loss and malnutrition may be caused by many factors, including type of disease and treatment. AIM: The present study investigated the occurrence of in-hospital weight loss and related factors. METHOD: This cross-sectional study investigated the following variables of 456 hospitalized patients: gender, age, disease, weight variation during hospital stay, and type and acceptance of the prescribed diet. Repeated measures analysis of variance (ANOVA) was used for comparing patients' weight in the first three days in hospital stay and determining which factors affect weight. The generalized estimating equation was used for comparing the food acceptance rates. The significance level was set at 5%. RESULTS: The most prescribed diet was the regular (28.8%) and 45.5% of the patients lost weight during their stay. Acceptance of hospital food increased from the first to the third days of stay (p=0.0022) but weight loss was still significant (p<0.0001). Age and type of prescribed diet did not affect weight loss during the study period but type of disease and gender did. Patients with neoplasms (p=0.0052) and males (p=0.0002) lost more weight. CONCLUSION: Weight loss during hospital stay was associated only with gender and type of disease. .

RACIONAL: A perda de peso e a desnutrição podem ser desencadeadas por vários fatores, além de estar relacionada com o tipo de doença e com a terapia empregada. OBJETIVO: Investigar a ocorrência de perda de peso e fatores relacionados, durante a internação. MÉTODO: Estudo transversal com 456 pacientes hospitalizados, sendo estudadas as seguintes variáveis: sexo, idade, doença, evolução de peso, tipo e aceitação da dieta prescrita. Para comparar o peso entre os três primeiros dias de internação e para o estudo dos fatores que interferiram na alteração do peso, foi utilizada a Análise de Variância (ANOVA) para medidas repetidas. Para comparar a proporção de respostas na aceitação da dieta, foi utilizado o método das Equações de Estimação Generalizadas (EEG), com nível de significância de 5%. RESULTADOS: A dieta mais prescrita foi a geral (28.8%) e 45.5% dos pacientes perderam peso durante a internação. A aceitação da dieta hospitalar melhorou do 1º para o 3º dia de internação (p=0.0022), mas mesmo assim, a perda foi significativa (p<0.0001). Verificou-se que a idade e o tipo de dieta prescrita não influenciaram na perda de peso no período; mas, o tipo de doença e o sexo, apresentaram influência nos pacientes portadores de neoplasias (p=0.0052) e o sexo masculino (p=0.0002) apresentou mais perda de peso. CONCLUSÃO: A perda de peso no decorrer da internação foi relacionada apenas ao sexo e ao tipo de doença. .

The mediating effects of test anxiety on the relationship between socially-prescribed perfectionism and academic burnout of female college students in a dental hygiene department / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to uncover the mediating effects of test anxiety on the relationship between socially prescribed perfectionism and academic burnout in enrolled in a dental hygiene department. METHODS: This study administered a survey consisting of the Socially Prescribed Perfectionism Scale, the Revised Test Anxiety Scale, and the Maslach Burnout Inventory-Student Survey to 310 female college students in the dental hygiene department at G City. The data were analyzed with correlation analysis using SPSS 21.0 and AMOS 20.0. partial mediating effects of test anxiety between socially prescribed perfectionism and academic burnout. RESULTS: The results suggest that the higher the levels of socially prescribed perfectionism, the greater the increase in academic burnout. In addition, socially prescribed perfectionism increases test anxiety when academic burnout is high. The analysis of mediating effects in the indirect path of the model revealed that adaptive socially prescribed perfectionism had a negative effect on academic burnout by increasing test anxiety. These findings and their implications were discussed. CONCLUSIONS: In order to reduce socially imposed perfectionism, it is necessary to reduce growing academic burnout, and test the value and success criteria of this model. There remains however, the fact that there is a need to focus on career goals and criteria that need to be met in order to be successful. By lowering test anxiety, psychological stability is improved and in turn, a stable college life enables dental hygiene students to more freely access psychological support. Therefore, a proactive attitude toward education is vital in preventing test anxiety and socially prescribed perfectionism.

Clinical Features of Drug-induced Liver Injury According to Etiology

Drug-induced liver injury (DILI) is an increasingly common cause of acute hepatitis. We examined clinical features and types of liver injury of 65 affected patients who underwent liver biopsy according DILI etiology. The major causes of DILI were the use of herbal medications (43.2%), prescribed medications (21.6%), and traditional therapeutic preparations and dietary supplements (35%). DILI from herbal medications, traditional therapeutic preparations, and dietary supplements was associated with higher elevations in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels than was DILI from prescription medications. The types of liver injury based on the R ratio were hepatocellular (67.7%), mixed (10.8%), and cholestatic (21.5%). Herbal medications and traditional therapeutic preparations were more commonly associated with hepatocellular liver injury than were prescription medications (P = 0.002). Herbal medications and traditional therapeutic preparations induce more hepatocellular DILI and increased elevations in AST and ALT than prescribed medications.

Encuesta sobre abuso de alcohol y medicamentos en adolescentes de cuatro escuelas del conurbano bonaerense / Survey on alcohol and medicine abuse among adolescents at four schools in Greater Buenos Aires

Introducción. El consumo de alcohol y medicamentos no prescritos en los adolescentes es un problema creciente en los servicios de toxicología. La "jarra loca" es una mezcla de bebidas alcohólicas y medicamentos que utilizan los jóvenes como modalidad de abuso. En los últimos años, además de psicofármacos, los jóvenes mezclan hipoglucemiantes, lo cual puede generar secuelas neurológicas o producir la muerte, dependiendo de la dosis ingerida y el tiempo de duración de la hipoglucemia. Objetivo. Estimar la prevalencia de consumo de alcohol y medicamentos en adolescentes de 12 a 18 años de edad que concurren a cuatro escuelas del partido de Tres de Febrero, de la provincia de Buenos Aires. Material y métodos. Estudio observacional, descriptivo y transversal. Se realizó una encuesta autoadministrada sobre consumo de alcohol y medicamentos en adolescentes de 12 a 18 años, de cuatro escuelas de la provincia de Buenos Aires. Se realizaron talleres para intercambio de conocimientos y experiencias con los alumnos y se entregó material gráfico informativo. Resultados. Se realizaron 977 encuestas. El 49% de los alumnos encuestados refirió consumir bebidas alcohólicas al salir con sus amigos. El 8% (n= 78) de los alumnos refirieron consumir "jarra loca" y el 49% refirieron que sus amigos lo hacían. Veintiún alumnos requirieron atención médica, al menos, en una oportunidad luego de haber tomado bebidas alcohólicas y 17 de estos habían consumido "jarra loca". El 55% de los alumnos desconocían el uso de las pastillas que mezclan en la "jarra loca". El 48% de los padres desaprueba el consumo de alcohol. Conclusión. El 49% refirió tomar bebidas alcohólicas. En nuestro trabajo, el 8% de los alumnos encuestados consumieron o probaron alguna vez "jarra loca", aunque el 49% afirmaron que sus amigos sí lo hacían.

Introduction.The use of alcohol and prescription drugs acquired without a prescription among adolescents has become an increasing problem at departments of toxicology. The "jarra loca" is a mix of alcoholic beverages and medicines abused by teens. In the past years, in addition to psychotropic drugs, adolescents have also added hypoglycemic drugs to the mix, which may cause neurological sequelae or even death, depending on the dose used and the duration of hypoglycemia. Objective.To estimate the prevalence of alcohol and medicine use among 12 to 18 year-old adolescents attending four schools in the district of Tres de Febrero, province of Buenos Aires. Material and Metfcods.Observational, descriptive and cross-sectional study. A survey on alcohol and medicine use was self-administered by 12 to 18 year-old adolescents from four schools in the province of Buenos Aires. During workshops, knowledge and experience were exchanged with students and infographic material was provided. Results.Nine hundred and seventy-seven surveys were completed. Of all surveyed students, 49% indicated that they have alcoholic beverages while out with their friends; 8% (n= 78) admitted drinking the "jarra loca" while 49% stated that their friends did. Twenty-one students required medical care at least once following alcohol consumption, and seventeen of them had drunk the "jarra loca." Fifty-five percent of students did not know what medicines are mixed in the "jarra loca" Forty-eight percent of parents discourage alcohol consumption. Conclusion.Forty-nine percent of students indicated that they have alcoholic beverages. In our study, 8% of surveyed students had consumed or tried the "jarra loca" once, although 49% referred that they friends did.

Prescripción basada en evidencia científica en la atención primaria de salud / Scientific evidence-based prescribing in primary health care

Introducción: la medicina basada en evidencia es una respuesta natural a la necesidad de crear un modelo de atención médica que permita la integración en la práctica diaria, de los resultados de los avances en materia de investigación clínica. Objetivos: caracterizar el uso de la medicina basada en la evidencia en el acto de la prescripción. Métodos: se realizó un estudio descriptivo de corte transversal, en el primer nivel de asistencia médica. Se incluyeron de manera aleatoria 9 provincias del país (Santiago de Cuba, Camagüey, Matanzas, Holguín, Pinar del Río, La Habana, Ciego de Ávila, Granma y Guantánamo) que constituyen el 60 porciento y de estas el 25 porciento de los policlínicos (82). La selección de estos se realizó por un muestreo aleatorio simple con el programa estadístico EPIDAT. Se incluyó 765 prescriptores que prestaban servicios en las áreas seleccionadas en el momento de la aplicación del instrumento. Para la recogida de la información se diseñó un cuestionario Prescribir con evidencia científica, con el objetivo de capturar toda la información relativa a las variables definidas. Resultados: más de la mitad de los encuestados (442) expresó que sentián la necesidad de buscar información frecuentemente; esta aumentó en los profesionales con experiencia, aunque la frecuencia anual con que lo hacen es baja, con un promedio de 6,48 veces al año y una moda de cero. Las interacciones medicamentosas fueron los aspectos de la prescripción acerca de los cuales los encuestados refirieron tener más dudas (69,4 porciento). Conclusiones: la mitad de los encuestados señaló que sentián frecuentemente la necesidad de consultar publicaciones científicas para dar respuesta a dudas relacionadas con el acto de la prescripción; sin embargo, la fuente que más empleron fueron los libros impresos y los cursos de actualización...

Introduction: evidence-based medicine is a natural response to the need of creating a healthcare model that allows the integration of the results of the advances in clinical research into daily practice. Objectives: To characterize the use of evidence-based medicine in the act of prescribing. Methods: We conducted a cross sectional study in the first level of care. We included, at random, 9 provinces (Santiago de Cuba, Havana, Matanzas, Pinar del Rio, Camagüey, Ciego de Avila, Holguín, Granma and Guantanamo) that constitute 60 percent and of these, 25 percent of the clinics (82). The selection of these was by simple random sampling with the statistical program EPIDAT. 765 prescribers were included since they were serving in the selected areas at the time of the application of this instrument. For the collection of information a questionnaire Prescribing scientific evidence was designed in order to capture all the information on the variables defined. Results: Over half of respondents (442) noted that often feel the need to seek information, this necessity increases when less time professional experience, although the frequency of seeking for more information is annually low, with an average of 6, 48 times a year and a mode of zero. Concerning prescriptions, the respondents reported having more questions (69.4 percent) about drug interactions. Conclusions: Half of the respondents stated that they often feel a need for review of scientific literature to answer questions during the act of prescribing. However, the sources they use are printed and updating courses. Interactions and adverse reactions are the aspects that they usually seek about, but they refer they often take into account the availability of the drug at the time of prescribing

Prevalence and predictors of self-medication in a selected urban and rural district of Sri Lanka

Background: Self-medication is widely practised in many developing countries. The determinants of self-medication need to be understood to design adequate medicine information policies and patient-dispenser education strategies. Hence, the prevalence of medicine use and predictors of self-medication were determined in Sri Lanka. Methods: In a community-based cross- sectional study, data were collected from 1800 adults selected from Gampaha and Polonnaruwa districts respectively. Study participants were sampled using a multistage cluster sampling technique. Trained public health midwives administered the questionnaire. Two Likert scales provided information on access to medical care and satisfaction with available pharmacy services. About 95% of the sampled population participated in the study. Results: Overall, prevalence of medication use (allopathic, traditional, home remedies) in urban and rural population was 33.9% and 35.3%, respectively. Self-medication prevalence of allopathic drugs in the urban sector (12.2%) was significantly higher than in the rural (7.9%) sector(p<0.05). In the urban sector, small household size and preference to have medicines from outside the pharmacies predisposed to self-medication. The higher acceptability of medical services and regularity of medical care decreased the likelihood of self-medication. In the rural sector, lower satisfaction about the healthcare providers’ concern for clients, lower satisfaction about affordability of medical care and higher satisfaction with technical competence of the pharmacy staff increased the likelihood of self-medication. In both urban and rural sectors, when symptom count increased, tendency to self-medicate decreased. Conclusions: Self-medication prevalence was higher in urban compared to rural areas in Sri Lanka. Some aspects of access to medical care, satisfaction with pharmacy services and perceived severity of the disease were found to be important determinants of self-medication.

"Quem dá mais, cobra mais!": Uma análise das normas antecedentes do ofício de motorista de ônibus em um contexto específico / "Who gives more, charges more!": An analysis about the job of bus driver in a specific context

O objetivo deste artigo é analisar o trabalho prescrito e as normas antecedentes do trabalho dos motoristas de ônibus de uma empresa de transporte urbano do município de Rio de Janeiro. O referido estudo baseou-se em conceitos vindos da Ergonomia e da Ergologia e em dados de outra pesquisa já realizada sobre o ofício de motorista de ônibus (CAIAFA, 2002). Contou ainda com uma pesquisa de metodologia qualitativa que buscou analisar a linguagem utilizada pelos responsáveis por transmitir as normas antecedentes e prescrições de trabalho de certa empresa de ônibus aos seus funcionários. O material para análise foi colhido a partir de duas situações: uma entrevista com um inspetor, que pelas atribuições de seu cargo tem como rotina observar, controlar e corrigir aspectos do trabalho dos motoristas e cobradores, e a participação em um processo de integração para funcionários recém-admitidos na referida empresa.

The goal of this article is analyze the prescribed work norms and the antecedent norms of the bus drivers work in a specific context. The reported study was inspired in the concepts given respectively for the Ergonomy and the Ergology, and in the observations from another research about bus journeys in Rio de Janeiro (CAIAFA, 2002). It counted also with a qualitative research methodology that sought to analyze the language used by the person responsible for the transmission of prescribed work norms and the antecedent norms of a certain company to its employees. The content for analyze was collected from two situations: an interview held with an inspector, with the assignments to observe, monitor and correct aspects of the bus driver’s work and conductor’s work, and the participant observation of a process of integration for admitted workers in the already mentioned company.

Evaluation of the use of topic nasal decongestants in university students from health sciences courses

Nasal decongestants in Brazil are available without prescription. They are one of the most requested medications in Brazil. The use of nasal decongestants, however, may lead to serious consequences. For this study, university students majoring in the health field were evaluated in terms of their profile regarding the use of nasal decongestants. Additionally, health sciences seniors were evaluated regarding their level of knowledge concerning the correct and proper use of nasal decongestants. Among the 71.8 percent of respondents who had already used topic nasal decongestants, 64.3 percent had used this medication for at least 15 days and 64.6 percent had started using it due to nasal obstruction. The gathered data indicate that the pharmacist was the main health professional reported as having provided patients with guidance on how to use this medication. A five-point Likert Type intensity scale (3.6 ± 0.08) shows that a regular level of knowledge has been observed among the students. Most of the students polled were concluded to incorrectly use topic nasal decongestants. Furthermore, the results of this study indicate that the future health professionals are not well prepared to promote health education for patients concerning the rational use of nasal decongestants.

Os descongestionantes nasais representam um dos grupos de medicamentos mais procurados dentro da automedicação no Brasil e as consequências ocasionadas pelo uso prolongado podem ser graves. Neste estudo foi aplicado a universitários da área de saúde um instrumento de avaliação para coleta de informações relacionadas ao perfil do uso destes medicamentos e outro instrumento para os alunos do último ano destas áreas para avaliar o nível de conhecimentos sobre o uso racional e correto dos descongestionantes nasais. Dos acadêmicos entrevistados, 71,8 por cento fazem ou já fizeram o uso de descongestionantes nasais tópicos e destes, 64,3 por cento utilizaram o medicamento por menos de 15 dias; 64,6 por cento iniciaram o uso do descongestionante devido à obstrução nasal. Os dados obtidos ainda mostraram o farmacêutico como principal profissional responsável pela orientação do uso do medicamento aos usuários. Foi observado nível de conhecimento regular por parte dos alunos, através da escala de intensidade de cinco pontos do tipo Likert (3,6 ± 0,08). Conclui-se pelo uso incorreto de descongestionantes nasais tópicos pela maioria dos entrevistados e que falta preparo aos futuros profissionais para correta educação aos pacientes.

Association of Prescribed Drug intoxication and Neuropsychiatric history

PURPOSE: The purpose of this study was to investigate the relationship between patients with a neuropsychiatric history and features of their suicide attempt, in order to analyze the risk associated with psychiatrist prescribed drugs. METHODS: We retrospectively investigated cases of intentional overdose drug ingestion in patients greater than 14 years of age who visited OO emergency medical center between January 1, 2008 and July 31, 2010. We evaluated patient medical records to ascertain their age, sex, neuropsychiatric history, and components of ingested intoxicant. Information regarding any suicide reattempt was obtained after discharge through follow up telephone survey. SPSS version 13.0 was used for statistical analysis. Fisher's exact test was performed with p<0.05 considered statistically significant. RESULTS: Ninety-six of 209 patients (46%) had a past history of psychological problems. Among those 96 patients with a history of psychological problems, 46(48%) used an overdose of the medicine prescribed by their psychologist in order to attempt suicide. However, for patients without a history of psychological problems, intoxication by neuropsychiatric drugs was insignificant. Neuropsychiatric patients required greater follow up care after discharge and exhibited significantly more suicide reattempts. CONCLUSION: This study revealed that patients sometimes use the medicine prescribed by their psychologist to attempt suicide. Therefore, an exhaustive plan to control the medicines prescribed to psychiatric patients should be established.

Monitoramento do uso de medicamentos prescritos em uma unidade de terapia intensiva / Vigilancia del uso de medicamentos recetados en una unidad de terapia intensiva / Surveillance of prescribed drug usage in an intensive care unit

O objetivo deste estudo foi analisar o uso de medicamentos prescritos para pacientes hospitalizados em uma unidade de terapia intensiva (UTI) de um hospital universitário em Recife, PE. Estudo prospectivo, observacional, durante 12 meses — agosto de 2004 a julho de 2005 —, foi realizado através de visitas diárias à unidade, aplicando-se um questionário para determinar os principais fármacos utilizados. Estiveram expostos a medicamentos, durante a hospitalização, 82 pacientes (47,6% homens e 52,4% mulheres); o diagnóstico mais frequente foram as doenças respiratórias (45,1%); a classe terapêutica mais prescrita foram os antimicrobianos (25,5%), anti-hipertensivos/antiarrítmicos (10,0%) e ansiolíticos/sedativos/hipnóticos (8,6%). Nenhum evento adverso foi observado. Cuidadoso monitoramento de pacientes usando vários medicamentos é necessário para reduzir a incidência de eventos adversos e erros de medicações, especialmente em relação às prescrições de antibióticos em UTIs.

The aim of the study was to investigate the use of drugs prescribed for patients hospitalized in an intensive care unit (ICU) of a university hospital in Recife, Pernambuco State. A prospective, observational study was carried out for 12 months – August 2004 to July 2005 – through daily visits to the unit to apply a questionnaire to determine the main drugs used. Eighty-two patients (47.6% male and 52.4% female) were exposed to drugs during hospitalization; the most frequent diagnosis was respiratory diseases (45.1%); the therapeutic classes most prescribed were antimicrobials (25.5%), followed by antihypertensives/antiarrhythmics (10.0%) and anxiolytics/sedatives/hypnotics (8.6%). No adverse event was observed. Careful monitoring of patients using several drugs is necessary to reduce the incidence of adverse drug events and medication errors, particularly as regards prescription of antibiotics in ICUs.

Este estudio examinó el uso de medicamentos recetados para pacientes hospitalizados en una unidad de cuidados intensivos (UCI) de un hospital universitario en Recife, PE-Brasil. Estudio prospectivo, observacional, durante 12 meses – de agosto de 2004 a Julio de 2005, fue cumplido por medio de visitas diarias a la unidad, aplicándose un cuestionario para determinar los principales fármacos utilizados. Fueron expuestos a medicamentos, durante la hospitalización, 82 pacientes (47,6% hombres y 52,4% mujeres); el diagnóstico más frecuente fueron las enfermedades respiratorias (45,1%); la clase terapéutica más prescrita fue los antimicrobianos (25,5%), antihipertensivos/antiarrítmicos (10,0%) y ansiolíticos/sedantes/hipnóticos (8,6%). No se observaron acontecimientos adversos. Vigilancia cuidadosa de pacientes con múltiples medicamentos es necesaria para reducir la incidencia de efectos adversos y errores de medicación, especialmente en relación a las prescripciones de antibióticos en UCIs.