Practices and Factors for Self-Medication with Antibiotics Among Patients and Medical Students in Tunisia: A Cross-Sectional Study
Mariam Ammar,
Mohamed Makhlouf,
Soufiene Triki,
Nour Ben Amor,
Rawia Makni,
Takwa Lefi,
Khaled Zeghal,
Ahmed Hakim,
Lobna Ben Mahmoud
Issue:
Volume 4, Issue 1, March 2023
Pages:
1-8
Received:
10 November 2022
Accepted:
25 November 2022
Published:
9 January 2023
Abstract: Self-medication with antibiotics (SMA) becomes generally common practice due to multiple factors. This study aimed to identify the prevalence and factors associated with SMA among patients and medical students in Tunisia. A cross-sectional study was conducted between March 2018 and October 2018 on 752 subjects. The sample of this study consisted of 153 patients in the outpatient clinic of two Universities Hospitals (Habib Bourguiba and Hedi Chaker in Sfax, Tunisia) and 559 students in the Medical universities of Tunisia. The inclusion criteria included adult patients (≥18 years) who see in one of both hospitals during the study and Medical students who accepted to access the questionnaire on Google forms. Data were collected through a structured questionnaire reliable and validated by a pilot test in a subsample of participants. Data were analyzed using SPSS. Student’s t-test and Mann-Whitney U test were used to compare differences between quantitative variables. Pearson's chi-square test was carried out to evaluate associations between qualitative variables. Of 752 participants, 71.68% self-medicated (70.9% of patients and 72% of medical students). There were no significant differences in SMA between patients and medical students (P=0.738). Amoxicillin was the most commonly used antibiotic for SM by patients (67.6%) and medical students (74.5%) (P=0.149). Furthermore, the most common indications for the use of self-medicated antibiotics were angina, influenza-like illness, and fever were the most frequent indications for the use of self-medicated antibiotics by patients (56.5%, 60.2%, 28.7%) and medical students (60.1%, 40.8%, 17.9%) (P=0.494, P=0.001, P=0.012). Furthermore, for reasons following previous experience, time-saving, and easy availability of drugs from pharmacies, the difference was statistically different between the two groups, with an increase in medical students compared to patients. The major source of information was pharmacies. Ninety-seven patients (90%) and 364 students (88.8%) got their antibiotics based on pharmacist consultancy. SMA is a common practice among patients and medical students in Tunisia. This infers the need for interventions to prevent the SMA, such as the implementation of appropriate health organizations for public education concerning the risks and consequences for the health of SMA.
Abstract: Self-medication with antibiotics (SMA) becomes generally common practice due to multiple factors. This study aimed to identify the prevalence and factors associated with SMA among patients and medical students in Tunisia. A cross-sectional study was conducted between March 2018 and October 2018 on 752 subjects. The sample of this study consisted of...
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End-Stage Renal Disease, Autoimmune Hepatitis, Alveolar Hemorrhage and ANCA Vasculitis as a Complication of Chronic Hepatitis B Virus: An Unusual Case Report
Ernestho-Ghoud Indretsy Mahavivola,
Soilihi Moustafa Abdou,
Vita Odon Anthony,
Rajaonarison Ny Ony Narindra Lova Hasina,
Ahmad Ahmad,
Rakotoarison Ratsaraharimanana Catherine Nicole,
Raveloson Nasolotsiry Enintsoa,
Vololontiana Hanta Marie Danielle
Issue:
Volume 4, Issue 1, March 2023
Pages:
9-13
Received:
31 January 2023
Accepted:
24 February 2023
Published:
9 March 2023
Abstract: Background: End stage renal disease, autoimmune hepatitis and alveolar hemorrhage have rarely been reported as the complications of hepatitis B virus infection that can potentially be triggered by an antibody-mediated vasculitis as a result of a viral infection. The following was a case report detailing a patient presenting with all three of the above presentations who was cytoplasmic antineutrophil cytoplasmic antibody-positive and a chronic carrier of hepatitis B virus. Case presentation: A 52-year-old Malagasy woman presented in our intensive care unit for acute respiratory failure with end-stage renal disease and deterioration in general condition. She was managed with steroids, non-invasive ventilation, and hemodialysis. Laboratory test showed elevated levels of serum creatinine and liver enzymes. An extensive workup was done to find the etiology of elevated liver enzymes. Only blood work that came back positive was for chronic inactive hepatitis virus B and positive autoantibody suggestive of autoimmune hepatitis. A computed tomography scan of her lung revealed features suggestive of bilateral alveolar hemorrhage. Workup for other causes of vasculitis, including anti-neutrophil cytoplasmic antibodies (ANCA) was positive for c-ANCA antibody to proteinase 3. Medical investigations allowed excluding other infectious diseases, malignancies and other rheumatic and vasculitis affections. Administration of lamivudine® orally was done. The patient was followed for more than one year and there were no other new systematic symptoms. Conclusion: This case report showed the possibility of hepatitis B virus-induced vasculitis as the cause of alveolar hemorrhage, autoimmune hepatitis, and end stage renal disease. The origin of these symptoms was attributed to immune complex-mediated vasculitis induced by antineutrophil cytoplasmic antibody.
Abstract: Background: End stage renal disease, autoimmune hepatitis and alveolar hemorrhage have rarely been reported as the complications of hepatitis B virus infection that can potentially be triggered by an antibody-mediated vasculitis as a result of a viral infection. The following was a case report detailing a patient presenting with all three of the ab...
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The Trajectories of Hepato-Biliary Indices Following Exposure to SARS-CoV-2
Kelachi Thankgod Wala,
Collins Amadi,
Stephenson Lawson,
Emmanuel Mustapha Owamagbe,
Nkeiruka Joyce Amadi
Issue:
Volume 4, Issue 1, March 2023
Pages:
14-21
Received:
27 March 2023
Accepted:
12 April 2023
Published:
24 April 2023
Abstract: Background: The impact of SARS-CoV-2 on the hepato-biliary system is conflicting within the existing literature. Previous studies on the subject have mostly been documented among Caucasians using retrospectively-acquired data from patients with several confounding variables. Hence, the current study evaluated the trajectories of hepato-biliary biochemical indices among SARS-CoV-2-infected Nigerians who had no background confounding factors. Methods: This was a prospectively-designed longitudinal study conducted within Southern Nigeria among patients with RT-PCR-confirmed mild SARS-CoV-2 infection. All eligible participants were serially monitored/followed up before, during, and after mild SARS-CoV-2 infection using clinical/laboratory parameters to determine the impact of the virus on the hepato-biliary system. Specimen acquisition, laboratory workflow, and data management were all carried out using standardized protocols. Results: Among 152 studied, 46.1% had mild SARS-CoV-2 infection 5–10 days (Mean=7.5; SD:=2.19) after exposure with male predominance. Cough, malaise, and loss of taste/smell were the most predominant clinical manifestations among the confirmed mild cases. During the follow-up period, an increasing trend of hepato-biliary indices of the cholestatic pattern (with only total bilirubin and GGT reaching statistically significant threshold) in parallel with inflammatory markers (CRP, di-dimer and the neutrophil to lymphocyte ratio) was observed between 2-12 days following mild SARS-CoV-2 infection. However, no relationship was established between these cholestatic and inflammatory markers among the mild SARS-CoV-2-infected patients (p>0.05). Conclusion: Mild SARS-CoV-2 infection is associated with altered hepato-biliary biochemical indices of cholestatic pattern independent of SARS-CoV-2-induced inflammatory events. Incorporating hepato-biliary assessment during the initial evaluation and the use of non-hepatotoxic therapeutics during treatment is highly recommended.
Abstract: Background: The impact of SARS-CoV-2 on the hepato-biliary system is conflicting within the existing literature. Previous studies on the subject have mostly been documented among Caucasians using retrospectively-acquired data from patients with several confounding variables. Hence, the current study evaluated the trajectories of hepato-biliary bioc...
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