ABSTRACT
The corona virus disease 2019 (COVID-19) pandemic has increased the interest in self-care strategies, including self-medication. Medical students, as future health practitioners, learn more about medications than other students. This study aimed to describe self-medication practices for preventing COVID-19 among medical students at Universitas Islam Indonesia. This observational study used a cross-sectional design and was undertaken in November- December 2020. The study sample included 336 undergraduate medical students determined using a consecutive sampling technique based on inclusion and exclusion criteria. Data were collected using an online questionnaire about self-medication practices in the preceding 3 months. Among a total of 336 students, 137 (41%) reported using self-medication intending to prevent COVID-19, and 126 (92%) of these 137 took preventive supplements, mainly vitamins C, D, and E, and omega-3. Seven students reported the use of zinc, mainly in combination with other vitamins. Students who practiced self-medication lived closer to people confirmed with COVID-19, washed their hands more often, and desinfected their belongings more frequently than their counterparts (p<0.05). The mean duration for consuming vitamins was 11-16 days. Forty students (29%) used herbal medicine to prevent COVID-19;ginger, turmeric, honey, black seed, cutcherry, and Curcuma were the most often consumed herbal remedies. Fourteen students (10%) reported taking over-the-counter medications to relieve symptoms related to COVID-19, including antipyretic, analgesic, antiseptic, antihistamine, decongestant, antitussive, and expectorant medications. Most respondents (82%) purchased their medications at pharmacies, and 11 (9%) obtained them from online shops. These findings show the high rate of self-medication using vitamins and herbal remedies for COVID-19 prevention among university medical students. Further studies are needed to explore students' knowledge about the risks of self-medication including the use of herbal medicines.Copyright © 2022 Marmara University Press.
ABSTRACT
Introduction: Acute kidney injury (AKI) requiring dialysis is an important health care burdenand is associated with very high in-hospital mortality. As no specific treatment is available toreverse AKI, the management remains supportive, including optimized fluid, electrolyte andacid-base balance, adjusting the dose of potentially nephrotoxic medications or avoidingsecondary haemodynamic and nephrotoxic kidney injury with timely initiation of dialysis.Timely initiation of dialysis in AKI is fundamental to achieve treatment goals and to providesolute clearance and removal of excess fluid while awaiting recovery of kidney function. Ifkidney function remains inadequate after a period of discontinuation from dialysis, it should bereinstituted by the foresight of the treating physician. The primary outcome of interest of thestudy was recovery of sufficient kidney function to discontinue haemodialysis therapy andcomplete recovery of renal function. Methods: This prospective observational study has beenconducted in the Department of Nephrology, Mymensingh Medical College Hospital,Bangladesh from September 2019 to February 2021. All adult patients in whom conventionalintermittent haemodialysis was initiated in the dialysis ward were included in the study. Allpatients were followed up till death or complete recovery or for a maximum period of six month.A structured data collection sheet was used to collect patients detail and recorded data wereanalyzed by IBM SPSS version 23. Results: A total of 134 patients of AKI requiring dialysiswere included in the study with the mean age of 42.3±15.7 years. Male (54.5%) were slightlymore than female with a male to female ratio of 1.2:1. Diabetes was present in 16 (11.9%)patients and hypertension was present in 47 (35.1%) patients. The causes of AKI weresepticaemia (35.1%), urinary tract infection (34.3%), surgery (18.7%), vomiting (16.4%),leptospirosis (11.2%), obstetric (10.4%), acute watery diarrhoea (9.7%), malignancy (8.2%), postrenal obstruction (8.2%), drugs (7.5%), rapidly progressive glomerulonephritis (6%), COVID-19(5.2%), rhabdomyolysis (4.5%), intestinal obstruction (3.7%), acute gastroenteritis (2.2%), waspbite (2.2%), organophosphorus compounds (OPC) poisoning (1.5%), starfruit toxicity (1.5%),haemolytic uremic syndrome (0.7%) and unknown (1.5%). Mean number of dialysis requirementwas 5.9±8.6 and length of hospital stay was 15.4±10.5 days. Out of 134 patients, 95 (70.9%)were discharged from hospital and 39 (29.1%) died in hospital. Total death of patients during thestudy period were 49 (36.6%) including home death of 10 (7.5%) patients. Complete recovery ofkidney function was achieved in 70 (52.2%) patients and partial recovery of kidney function whocan survive without dialysis were observed in 12 (9%) patients. 3 (2.2%) patients remain ondialysis and total survival during the study period was observed in 85 (63.4%) patients. Survivalrate was significantly higher in patients with ≤ 40 years (72.6%) and significantly lower inpatients with malignancy (18.2%) and post renal obstruction (27.3%). Conclusions: Outcomes ofacute kidney injury in patients requiring dialysis remains poor. Early detection, optimization offluid and electrolyte balance and timely initiation of haemodialysis are the keys to improvesurvival and overall mortality. No conflict of interest