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
Bronchopulmonary diseases are an urgent problem for practical health care, as they are a frequent complication of acute respiratory viral infections (ARVI), which have a very high incidence in all age groups of the population, and especially among children. The novel coronavirus infection (COVID-19) pandemic, which the world faced in 2019, convincingly confirmed these facts. Therefore, effective pathophysiological treatment of patients with bronchopulmonary diseases is the most important task of modern pharmacotherapy. The 2 most important highly effective mechanisms for protecting the respiratory tract from pathogenic agents that provide the drainage function of the respiratory tract are described: mucociliary transport and cough. When pathological processes occur in the tracheobronchial tree (various bronchopulmonary diseases), the rheological properties of the bronchial secretion, structural and functional characteristics of the mucous membrane and submucosal layer of the airways change. This leads to mucostasis, a violation in the system of mucociliary transport – a key mechanism for protecting the respiratory tract from pathogenic agents, which significantly complicates the course and treatment of bronchopulmonary diseases, because mucostasis contributes to the violation of bronchial patency and the occurrence of atelectasis. Multfactorial is a distinc-tive feature of changes in mucociliary transport in bronchopulmonary diseases and requires a complex pharmacological action aimed at its normalization. Therefore, pathogenetic therapy aimed at restoring all the key factors of mucociliary transport is targeted in the treatment of various bronchopulmonary diseases. Mucoactive drugs that belong to different pharmacological groups, the use of which is aimed at restoring mucociliary transport, are considered. The necessity of using combined mucoactive drugs for the treatment of patients with bronchopulmonary diseases has been substantiated. © The Authors.
ABSTRACT
CASE: A 30-year-old woman with a history of hypertension, obesity, and reactive airway disease presents with a two-month history of persistent cough, wheeze, and diaphoresis. At that time, chest x-ray and COVID-19 PCR were negative and pulmonary function tests were within normal limits. Her symptoms were managed with inhaled corticosteroid/long-acting muscarinic antagonist, albuterol, guaifenesin, and second-generation antihistamines. However, she continued to be symptomatic. Two months after these symptoms arose, she presented to the ED with a sixhour history of sudden onset right non-radiating flank pain. Her symptoms were associated with acute onset nausea, vomiting, urinary frequency, urgency, hesitancy, and burning;negative for hematuria. She was hemodynamically stable and physical exam was significant for right flank tenderness. Urinalysis showed proteinuria of 100 mg/dL and gross hematuria. Imaging of the abdomen demonstrated an enlarged right kidney with a large mass involving the cortex with mass effect on the liver. Urology performed a right radical nephrectomy with pathology positive for chromophobe renal cell carcinoma. Following surgery, the patient's original symptoms of cough, wheezing, and diaphoresis resolved. IMPACT/DISCUSSION: The typical symptomatic presentation of renal carcinoma with flank pain, abdominal mass, hematuria, and weight loss occurs in roughly 9% of cases and is indicative of advanced disease. Renal cell carcinoma is most commonly found incidentally on imaging studies, leading to improved outcomes due to early recognition. Young patients, however, are more likely to present symptomatically. Our patients' initial presentation of cough could be due to two different mechanisms. One possibility is chronic irritation of the diaphragm due to mass effect from the growing tumor. This mechanism is possible in our case as there was minor mass effect on the liver which could then disturb the diaphragm. A more likely mechanism is a paraneoplastic process. This has been demonstrated in prior cases with a chronic unremitting cough associated with diaphoresis, not improved with anti-tussives, and resolves upon removal of the mass. The cough has been shown to return with metastases. The proposed mechanism is tumor secretion of prostaglandins which enhance the cough reflex. Our case displays an uncommon symptomatic presentation of renal cell carcinoma in a young woman due to paraneoplastic cough stimulation. This demonstrates the importance of digging deeper when common symptoms such as cough are not successfully resolved with typical treatments. CONCLUSION: Most commonly renal cancer is diagnosed on incidental imaging allowing clinicians to make a diagnosis before symptoms arise. An unremitting cough may be an early warning sign of renal cell carcinoma before urinary symptoms begin, making early diagnosis more likely. Due to this, seemingly minor symptoms such as cough should be followed through to diagnosis as they can have significant consequences.
ABSTRACT
Methods: A protocol applying Cochrane rapid review methods was registered with PROSPERO: (CRD42020193847) in July 2020. Four English databases plus preprint servers and trial registries were searched for randomised controlled trials (RCTs). The evidence was appraised using RoB 2.0 and GRADE-approach. Results: 27 results, derived from 9 RCTs, included 674 adults and 781 children. In Hospitalized patients with confirmed SARS-CoV-2 infections, propolis plus usual care compared to usual care alone, reduced the risk of shock, (RR:0.36;95%CI:0.15, 0.88), respiratory failure (RR:0.32;95%CI:0.11, 0.92), and kidney injury (RR:0.36: 95% CI:0.15, 0.88) (all low-certainty) and duration of hospital admission (MD:-3.81 days, 95%CI:-6.19, -1.44) (moderate-certainty). Compared to coffee, honey plus coffee and honey alone, reduced the severity of post-infectious cough of a least 3-weeks duration in adults (MD:-1.40, 95%CI:-1.67, -1.13) (low-certainty) and (MD:-0.40, 95%CI:-0.75, 0.05) (very low-certainty) respectively. Honey was less effective than Guaifenesin in reducing cough severity at 60-minutes in adults with non-specific acute RTIs (MD:0.20 points, 95%CI: 0.05, 0.35) (very low-certainty). Honey compared to placebo reduced the duration of cough in children (MD:-0.71 days 95% CI:-1.15, -0.28) and compared to salbutamol (MD:-0.54 days 95%CI:-0.99, -0.09) (low-certainty);and the global impact of paediatric nocturnal cough was reduced by honey plus usualcare compared to usual-care alone (SMD:-0.80, 95%CI:-1.28, -0.32) (very low-certainty) and pharmaceutical cough medicines (SMD:-0.75 95%CI:-1.13, -0.36) (low-certainty). Background: This rapid review systematically evaluated the effects of honeybee products compared to controls for the duration, severity, and recovery of acute viral respiratory tract infections (RTIs), including SARS-CoV-2, in adults and children. Conclusion: More RCTs are needed to robustly inform the role of honey and propolis for treatment of SARS-CoV-2 and related respiratory infections.
ABSTRACT
Facing the pandemic COVID-19 is of highest priority for all researchers nowadays. Recent statistics indicate that the majority of the cases are home-treated. Two drugs of interest, Guaifenesin and Bromohexine HCl, are among the add-on therapy for treatment of COVID-19 mild cases, which has raised the need for their simultaneous determination. The analysis of the two drugs of interest was described using ultra-performance liquid chromatography-tandem mass spectrometric (UPLC-MS/MS) in plasma of healthy human volunteers using tetryzoline HCl as an internal standard (IS) after liquid-liquid extraction. The applied chromatographic conditions were Kinetex C18 (100 Å, 2.6 µm X 50 mm X 4.6 mm) column and a mixture of methanol: water (95: 5, v/v) as a mobile phase at flow rate 1 mL/min. The positive ionization mode was used for detecting the ions, by observing the pairs of transition m/z 199 < 125 for GUF, m/z 377 < 114 for BRM and m/z 201 < 131 for IS. The linearity range was from 50 to 1500 ng/mL for GUF and 0.5-50 µg/mL for BRM. Limit of detection (LOD) was found to be 35.16 and 0.43 ng/ml for GUF and BRM, respectively. The method was validated according to FDA guidance. The proposed method was assessed to be more eco-friendly versus the reported method using the greenness assessment tools: National Environmental Methods Index (NEMI), Assessment of Green Profile (AGP), Green Analytical Procedure Index (GAPI) and Eco-Scale. The proposed method was applied for the application of a pilot pharmacokinetic study.