University Students' Self-Medication Practices and Pharmacists' Role: A Cross-Sectional Survey in Hail, Saudi Arabia

Background: Self-medication is an important issue for health authorities around the world. It is also a common practice among university students.Objective: This study aimed to assess the prevalence of and reasons for self-medication among university students.Methods: A descriptive, cross-sectional community based survey design was adopted for the current study. All the students enrolled in Hail University, Saudi Arabia were selected to include in the study. Data was collected from February to April 2020 using a validated questionnaire and were analyzed using IBM SPSS Statistics, Version 22.0. Using convenient sampling technique, the total sample size calculated was 370 participants. A descriptive analysis was performed. Chi-square test and binary logistic regression was used for analyzing the data where statistical significance was set at p ≤ 0.05.Results: A total of 373 participants completed the questionnaire. The response rate was 84%. The overall prevalence of self-medication among the students was 98.2%. Of the 373 participants, 40.8% were men, and 59.2% were women. Furthermore, 56% were in fields other than health sciences, 23.1% were in preparatory foundation courses, and 20.9% were from the health and medical sciences. The most frequent medical condition that led to self-medication was headaches (92.85%), followed by coughs (37.5%), colic (31.9%) and influenza (30.3%). On univariate analysis, it is revealed that for both abdominal colic [OR 0.54 (0.34–0.86), p = 0.01] and constipation [OR 0.57 (0.32–1.02), p 0.05], female gender was observed significantly with low prevalence than male. However, for influenza, the self-medication prevalence [OR 1.86 (1.19–2.91), p = 0.006] observed was significantly higher in female participants than male. A significant association (p = 0.011) between the self-medication factors and gender was shown in the current study results.Conclusion: An alarming prevalence of self-medication among the students was recorded. Health care providers can increase awareness of the issue by educating individuals about the harmful effects of irresponsible self-medication.

Nationwide questionnaire data of 229 Williams-Beuren syndrome patients using WhatsApp tool

ABSTRACT Background: Williams-Beuren syndrome is a multisystemic disorder caused by a microdeletion of the 7q11.23 region. Although familial cases with autosomal dominant inheritance have been reported, the vast majority are sporadic. Objective: To investigate the main complaints and clinical findings of patients with Williams-Beuren syndrome. Methods: A total of 757 parents of patients registered in the Brazilian Association of Williams-Beuren Syndrome (ABSW) received a questionnaire via WhatsApp from March to July 2017. Results: In total, 229 parents answered the survey. Age of diagnosis ranged from 2 days to 34 years (median: 3 years). The main clinical findings reported by the parents were abdominal colic (83.3%), failure to thrive (71.5%), feeding difficulty in the first year (68.9%), otitis (56.6%), urinary tract infections (31.9%), precocious puberty (27.1%) and scoliosis (15.9%). Cardiac defects were present in 66% of patients, and the most frequent defect was supravalvular aortic stenosis (36%). Arterial hypertension was reported in 23%. Hypercalcemia was reported in 10.5% of patients, mainly during the first year of life. Hyperacusis and hypersociability were common complaints (both present in 89%). Other behavioral and neuropsychiatric symptoms reported by the parents included attention deficit (89%), anger crises (83%), excessive fear (66%), depression (64%), anxiety (67%) and hypersexuality (33%). The most common complaints were hypersensitivity to sounds, talkative personality, emotional dependence and learning difficulties. In 98.3%, the parents denied family history. Conclusions: Williams-Beuren syndrome requires close follow-up with different medical specialties due to their variable clinical comorbidities, including language and school learning difficulties, behavioral and psychiatric problems.

First report of cryptosporidiosis among Iraqi children

Of 240 Iraqi children under five years old with a primary diagnosis of gastroenteritis and dehydration, 22 were excreting Cryptosporidium oocysts in their stools. This is the first reported occurrence of cryptosporidiosis among Iraqi schoolchildren. Samples were collected and examined by the modified Ziehl-Neelsen method between March and November 1994. The frequency distribution of Cryptosporidium among 114 positive cases with intestinal parasites was 18.3%. The boy-to-girl ratio was 1:2 among the Cryptosporidium-positive children. Most patients complained of abdominal colic and watery diarrhoea and were clinically dehydrated. The associated symptoms were fever and vomiting. Cryptosporidium and Giardia appeared to be associated

Study on outcome of guided newborn care in postnatal ward and common practices of newborn care among mothers followed in outpatient department at Hi-Tech medical college and hospital, Bhubaneswar

Background: Neonatal period is the most vulnerable phase in a child's life. The aim and goal of newborn care is not only to reduce neonatal mortality but more importantly to ensure their survival to the fullest. The neonatal mortality rate of India is 22 per 1000 live births. The neonatal period is only for 28 days yet it accounts for significant deaths under 5 years of age. Newborn morbidity and mortality contribute significantly to the infant mortality and under-five mortality rates in developing countries. About two-thirds of all infant deaths and 38% of all under-five deaths occur during the neonatal period, resulting in about 4 million neonatal deaths globally per year. Infant and under-five mortality ratio in developing countries have declined significantly in the past couple of decades, yet neonatal mortality rates have remained relatively static. The objective of this study was to understand the outcome of guided newborn care along with the patterns and determinants of essential newborn care and practices.Methods: A prospective cohort study was done among newborns in the postnatal ward and the outpatient (OPD) based newborns at HMCH Bhubaneswar from July 2020 to June 2021. The mothers in the postnatal ward were taught cord care, skin care, optimal thermal care and neonatal feeding practices. The regular follow-up was done maximum up to 7 days. Newborn who came to OPD were evaluated on perspective of essential newborn care and practices, followed by their mothers at home. A questionnaire was formulated for the OPD based patients to be answered before and after guidance.Results: 100 early neonates were taken (N=50 from postnatal ward and N=50 from OPD). Out of 50 neonates in the postnatal ward. 4 (8%) had abdominal colic, 10 (20%) had skin rashes, 2 (4%) had fever, 5 (10%) had feeding issues and 9 (18%) had neonatal hyperbilirubinemia respectively. In OPD neonates 3 (6%) were diagnosed with early onset neonatal sepsis (EONS), 7 (14%) had refusal to feed, 12 (24%) had skin rashes, 5 (10%) had abdominal colic, 14 (28%) were applying coconut oil and 7 (14%) developed hyperbilirubinemia. Whereas in OPD 5 (10%) neonates needed admission NICU and rest were managed symptomatically.Conclusions: Newborn care education and guidance helped in reduction of EONS, in gaining appropriate weight, in delivering optimal thermal care, practicing healthy skin care and implementing proper feeding techniques. All mothers need proper counselling and guidance in essential newborn care.

Intussusception in Adult due to Lipomatous Polyp - An Uncommon Case Report

Intussusception, invagination of a segment of the gut into an adjacent one, is a relatively common cause of the intestinal obstruction in children but a very rare and uncommon clinical entity in the adults accounting to 1% and near about 65% of these are caused by malignant lead point. The Lipomatous polyp accounts for 4% of all benign tumors of the gut. In most of the cases, these are seen particularly in large intestine, usually sub mucosal and around ileocecal valve. These are mostly and very often asymptomatic. Mrs. Rahima Begum aged 65 years, previously was a healthy Bangladeshi housewife, with the history of recurrent abdominal colic of moderate intensity for the last 6 months, associated with the appearance of mass in the right lower quadrant with features of sub-acute intestinal obstruction got admitted into the Ibn Sina Medical College Hospital, Kallyanpur, Dhaka, Bangladesh. The required and most relevant investigations revealed the Ileocolic intussusception and underwent the right hemicolectomy. Postoperative recovery of the patient was uneventful excepting the hypertension only. Histopathology investigations revealed lipomatous polyp arising from the Ileocecal junction. This study reports intussuception in the adult due to lipomatous polyp, a very rare case presenting with sub acute intestinal obstruction. Bangladesh Journal of Medical Science Vol.20(1) 2021 p.204-207

Clinical profile of patients with intussusception in a tertiary care institution in South India

Background: Intussusception is a common abdominal emergency in children. It is the most common cause of intestinal obstruction in children less than 2 years. Awareness about the clinical presentation vomiting, abdominal pain, blood in stools, abdominal mass helps in early diagnosis. This study describes the demographics and clinical profile of patients with intussusception in a tertiary care institute in South India.Methods: This was a prospective case series study conducted in the pediatric surgery department in a tertiary care hospital in South India. Children upto 12 years with clinically and radiologically confirmed intussusception were enrolled over 12 months study period. Demographic and clinical data was collected and recorded.Results: Eighty two children with clinical and radiological picture suggestive of intussusception were studied. 57 patients (75%) were below 1 year of age. Male:female ratio was 1.7:1. The classical triad of abdominal colic, palpable abdominal mass and rectal bleeding was seen in 39 patients (50%). Most common signs were rectal bleed and abdominal mass.Conclusions: Awareness about the clinical presentation of intussusception helps in early diagnosis and prompt treatment of this common pediatric emergency and helps to prevent mortality.

Macro and microscopic characters of Maerua oblongifolia (Forssk.) A. Rich leaf

The paper deals with a detailed investigation on the leaves of Maerua oblongifolia (Forssk.) A. Rich. which includes it’s morphological, anatomical and powder analysis. It is a low woody bushy under-shrub belonging to the family Capparaceae. The leaves are used in treatment of as fever, ear ache, stomach ache, skin infections, urinary calculii, diabetes mellitus, epilepsy, rigidity in lower limbs, and abdominal colic. The leaf amphistomatic, with mostly anamocytic, few tetracytic stomata. In transverse section of leaf is ribbed on either sides at midvein, epidermis one layered. Mesophyll differentiated into palisade and spongy tissues. Ground tissue of midvein differentiated into palisade, collenchyma and parenchyma. The midvien consists of one large oval shaped vascular bundles arranged are at the centre. Petiole in transverse section is circular adaxially small, grooved at centre and epidermis is having one layered, a single circular vascular bundle present at the centre, vascular bundle is enclosed by endodermis. The powder microscopic and organoleptic characters are also presented in this study. This study would helps as an appropriate source for authentification of the present studied drug.

Rare cases of severe life-threatening lead poisoning due to accident or chronic occupational exposure to lead and manganese: Diagnosis, treatment, and prognosis

Background: Chronic long-term, low-dose environmental and occupational exposure to lead (Pb) has been extensively studied in large cohorts worldwide among general populations, miners, smelters, or battery workers. However, studies on severe life-threatening Pb poisoning due to accidental or chronic occupational exposure to Pb and manganese (Mn) were rarely reported. Methods: We present one case of acute severe Pb poisoning and compare it with another severe chronic occupational exposure case involving Pb and Mn. A 27-year-old woman mistakenly took a large quantity of pure Pb powder as an herbal remedy; she developed abdominal colic, severe nausea, vomiting, fatigue, and cutaneous and sclera icterus. Laboratory tests showed her blood lead level (BLL) of 173.5 µg dL−1 and urinary lead level (ULL) of 1240 µg dL−1. The patient was diagnosed with acute Pb poisoning and acute liver failure. In another chronic exposure case, a 56-year-old man worked in a Pb and Mn smelting factory for 15 years. He was brought to the emergency room with severe nausea, vomiting, and paroxysmal abdominal colic, which was intolerable during the onset of pain. His BLL was 64.8 µg dL−1 and ULL was 38 µg dL−1, but his blood and urinary Mn levels were normal. The patient was diagnosed with chronic Pb poisoning. Both patients received chelation therapy with calcium disodium ethylene-diamine-tetraacetate (CaNa2EDTA). The woman with acute severe Pb intoxication recovered well and was discharged from the hospital after treatment, and the man who survived severe Pb poisoning was diagnosed with lung cancer. Conclusion: Clinical manifestations of acute and chronic severe Pb poisoning are different. Chelation therapy with CaNa2EDTA is proven to be an effective life-saving therapy in both cases by reducing BLL. Occupational exposure to both Pb and Mn does not appear to increase Mn neurotoxicity; however, the probability that co-exposure to Mn may increase Pb toxicity in the same patient cannot be excluded.

Safety of in-neonatal intensive care unit administration of rotavirus vaccination among preterms

Background Rotavirus is among the most common vaccine preventable illness in children under 5 years old. Despite increased severity of rotaviral illness in early infancy, most neonatal intensive care units (NICUs) do not administer rotavirus vaccination. The present project aims to evaluate the safety of in-neonatal intenive care unit administration of the monovalent live, attenuated rotavirus vaccination to preterm newborns in Sicily. Methods From the first of March 2018 within the six most important NICUs of Sicily (three located in Palermo, two in Catania and one in Messina), and under the scientific coordination of the University of Palermo and of the Regional Health Department, rotavirus vaccination was administered to preterm newborns with gestational age ≥28 weeks. Vaccine administrations were performed both under hospital and outpatient settings, from 6 weeks of age and in accordance with the Sicilian Vaccination Schedule. Results At the end of December 2019, 449 preterm newborns were fully vaccinated (two dose completion) against rotavirus in the six Sicilian NICUs participating to the project. Average gestational age was 31.4 (SD ± 2.7) weeks. First dose of rotavirus vaccination was administered at 6.3 (SD ± 0.6) weeks. Average weight at first dose were 2.890 (SD ± 0.456) grams. Only 8% and 2% of vaccinated newborns reported abdominal colic and fever >38.5 °C in the 15 days after first dose, respectively. No one expected adverse event was observed in the 30 days after vaccination. Conclusions First data obtained from this study confirms the absolute safety of monovalent rotavirus vaccination also in preterm newborns with gestational age ≥28 weeks. Results could represent for public health physicians and for neonatologists a key tool for standardize rotavirus vaccination in very Italian NICU. Key messages Rotavirus vaccination is extremely safe in preterm newborns with gestational age ≥28 weeks. Rotavirus vaccination should be routinely implemented in Italian and European NICUs.