Self-medication among medical students in Anbar and Fallujah Universities – Iraq

Background: Self-medication (SM) is a worldwide issue, that has serious adverse effects on individuals and communities. Objective:  To estimate the prevalence of self- medication   among medical student in Anbar and Falluja Universities and to explore the important reasons for using self-medication.  To identify the common sources and types of self-medication drugs. Method: A descriptive cross-sectional study was carried out among medical students in Anbar   and Fallujah Universities during the period from February to March 2018.  The subjects were asked to fill a questionnaire that consisted of questions on age, gender and educational level, in addition to questions for self-medication history. Results: The results revealed that 73% of medical students had practice of self- medication. A higher prevalence of self-medication was  found among 5th study year students. Antibiotics were the most frequent self-prescribe medicine that used by 137 (49.6%) of the participants, followed by analgesic (29%), and supplements by 40 (14.5%).  The most frequently given reasons for using self-medication were previous prescription and of pharmacists’ advice. Conclusion: A high prevalence of self- medication was found among medical students in Falluja & Anbar Universities with a statistical significant association between gender and self- medication practice

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Effect of proton pump inhibitors on Magnesium levels in Type II diabetic patients: a single centre study from Saudi Arabia

OBJECTIVE: In recent years, increasing evidence suggests an association between low Magnesium levels and type 2 diabetes mellitus. It has also been reported that the use of proton pump inhibitors may induce hypomagnesemia. Although some case reports have described patients with Proton Pump Inhibitor-induced hypomagnesemia, the impact of Proton Pump Inhibitor use on hypomagnesemia has not been fully clarified in comparative studies. The objective of the study was to determine the Magnesium levels in patients with diabetes who are taking proton pump inhibitors and also to correlate the Magnesium levels in diabetic patients who take proton pump inhibitors with those not taking proton pump inhibitors. PATIENTS AND METHODS: A cross-sectional study was carried out in the study population comprising adult patients attending internal medicine clinics in King Khalid Hospital, Majmaah, KSA. A total of 200 patients who gave informed consent were recruited into the study over one year. RESULTS: Overall prevalence of hypomagnesemia was observed among 128 patients out of 200 (64%) diabetic patients. Relatively more patients with hypomagnesemia were found in group 2 (without PPI use) (38.5%) compared to group 1 (with PPI use) (25.5%). A statistically significant difference was not observed in group 1 using proton pump inhibitors and group 2 not using proton pump inhibitors (p-value = 0.473). CONCLUSIONS: Hypomagnesemia is seen in diabetic patients and patients who take proton pump inhibitors. There was no statistically significant difference in Magnesium levels in diabetic patients, irrespective of proton pump inhibitor use

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980–2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1

10.1016/s0140-6736(21)00984-3The Lancet39810299503-52