Prevalence of intestinal parasites in Afghan community on the example of patients treated in Ghazni Provincial Hospital

Background: This study concerns parasitological investigations estimating the prevalence of intestinal parasites in the Afghan community based on the example of patients, both children and adults, treated inthe Ghazni Provincial Hospital, in the eastern part of the country.Materials and methods: In total, 201 admitted patients with internal health problems were examined in the Afghan hospital in March 2012, including 164 children (1–17 years old) and 37 adults aged 18–80. Stool samples were tested in the Department of Epidemiology and Tropical Medicine at the Military Institute of Medicinein Gdynia, Poland using 3 parasitological methods: direct smear, decantation, flotation (light microscopy).Results: Intestinal parasitic infections caused mainly by Ascaris lumbricoides, Giardia intestinalis and Hymenolepis nana were confirmed in 81/164 (49.4%) children examined. Among adults, 9/37 (24.3%) patients were infected with intestinal parasites including Ascaris lumbricoides and Giardia intestinalis.Conclusions: The Afghan community, living in poor sanitary conditions with limited access to health services, is one of the most infected populations in the world. The parasitological investigation focused on intestinal parasites performed by the Polish health service among the eastern Afghan inhabitants is still one of the few screening studies in this country

Intestinal parasites in Polish community on the example of military environment

Background: The epidemiological situation concerning the prevalence of the majority of intestinal parasites in Poland has not been investigated in recent years and therefore is not known. Information on the prevalence of nematodes and most of cestodes is acquired from the studies carried out in Polish research centres. The aim of this study was to evaluate the occurrence of intestinal parasites among Polish soldiers who served in harsh environmental conditions in Afghanistan and their families living in Poland. The relation between the rates of infections in military personnel and in their families in the context of the risk of importing intestinal parasites from Afghanistan to Poland was also analysed in this article. Materials and methods: 264 families consisting of 803 persons took part in the study which was conducted in the period May 2011 – December 2012. Stool samples were subjected to parasitological examination in the Military Institute of Medicine, Poland. The tests were performed by means of three diagnostic methods (direct smear, decantation, flotation). The study population comprised 264 married soldiers and 539 civilians (soldiers’ wives and children) living permanently in urban areas in Poland. Results: Intestinal parasites were diagnosed in 4/264 studied soldiers (1.5% infected with Ascaris lumbricoides, Giardia intestinalis), in 9/253 studied women (3.6% infected with A. lumbricoides, Hymenolepis nana, Taenia spp.) and in 5/286 children (1.7% infected with A. lumbricoides, G. intestinalis). There was no more than one infection per one household. Conclusions: The occurrence of intestinal parasites among Polish soldiers shows the possibility of importing pathogens from the Third World countries. It also indicates, in the context of infected women and children, that the source of infection of parasites of the digestive tract can be present in Poland

Deworming Campaign in Eastern Afghanistan – Prevalence of Intestinal Parasites and Adoption of Treatment Strategy

Purpose: To estimate the prevalence and species of intestinal parasites in an Afghan community as well as to establish appropriate treatment method for each of the detected pathogens.Methods: Parasitological examination of stool samples collected from 777 children aged 1-17 years, treated in Ghazni Provincial Hospital (eastern Afghanistan) conducted in the period 2012 - 2013 made it possible to implement dedicated antiparasitic treatment.Results: Of 312 children (40.2 % of the examined group; p < 0.05) infected with nematodes (n = 154, 19.7 %), cestodes (n = 90, 11.6 %), trematodes (n = 16, 2.1 %), and protozoa (n = 135, 17.4 %), 67 were diagnosed with co-infections (mainly ascariasis + giardiasis, ascariasis + hymenolepiasis, giardiasis + hymenolepiasis, ascariasis + giardiasis + hymenolepiasis) and received complex therapy (albendazole + metronidazole, albendazole + praziquantel, metronidazole + praziquantel, and albendazole + metronidazole + praziquantel).Conclusion: Owing to high prevalence of multiple co-infections among inhabitants of the Afghan community, it seems that a mass deworming campaign with a single-dose chemotherapy (albendazole 400 mg or mebendazole 500 mg) may prove ineffective in eradicating intestinal parasites in the local population.Keywords: Afghanistan, Intestinal parasites, Hymenolepiasis, Ascariasis, Giardiasis, Metronidazole, Albendazole, Praziquantel, Mebendazole, Dewormin

Factors determining the financial effectiveness of outsourcing in medical entities in Poland

The aim of the paper was to analyze the financial efficiency of outsourcing in connection with basic and auxiliary activity of medical entities in Poland. Research material consisted of 755 questionnaires filled in by the representatives of medical entities. Five of them were completed only partially, and thus they were not qualified for analysis, which means that complete analysis was performed in 750 medical entities, selected at random from the Register of Health Care Providers. The analysis of medical entities was performed in connection with outsourcing activities. The following auxiliary services were examined: cleaning, laundry, catering, property security and waste disposal, together with the services connected with basic activity, such as: medical staff, medical imaging, laboratory diagnostics. Each area was analyzed in connection with the reason for transferring a given activity to an external company, benefits and disadvantages obtained in connection with separating the service from the entity's structure as well as the method for monitoring the external company. Economies that medical entities gained compared to the costs of the same function before its separation were analyzed, together with the fact whether employees of the entity were given the job in the medical entity after its restructuring or not. All of the abovementioned areas were analyzed with relation to entity type, following the division into public and non-public entities

Czynniki socjodemograficzne a zjawisko samoleczenia bólu w Polsce

Introduction. Self-healing applies to the use of non-prescription drugs, as well as nutritional supplements, and herbal plant products for the treatment of diseases and symptoms diagnosed single-handedly. The aim of this study is to evaluate the impact of socio-demographic factors on the phenomenon of self-healing pain among Poles. Material and method. The study involved 218 randomly selected respondents, 159 women and 59 men. The tool was a questionnaire designed for the study. Collected data were analyzed using cross tables. Results. During six months before the start of the study 90% of respondents used the analgesics. Women declared that they took pain medication several times a month, three times more often than men. The type of pain for which respondents most frequently used the self-treatment is varied by gender as well as age and type of professional activity of the studied group. The most important factor in the purchase of the drug among the oldest patients is usually the pharmacist's advice (47.1% of the group), and among the youngest respondents - previous use of the drug (62.5%). About 70% of respondents admit that they use the Internet to obtain information about medicines. Conclusions. The most important element in the development of responsible self-treatment is education, in terms of both responsible consumption of analgesics, and the use of appropriate sources concerning the treatment of these diseases.Wprowadzenie. Samoleczenie dotyczy głównie stosowania leków wydawanych bez recepty, ale również suplementów diety, produktów roślinnych i ziół w leczeniu chorób oraz objawów rozpoznanych samodzielnie. Celem pracy jest ocena wpływu czynników socjodemograficznych na zjawisko samoleczenia bólu przez Polaków. Materiał i metoda. W badaniu udział wzięło 218 losowo wybranych respondentów, 159 kobiet oraz 59 mężczyzn. Narzędzie stanowił kwestionariusz skonstruowany na potrzeby badania. Zabrane dane poddano analizie tabelarycznej z wykorzystaniem tabel krzyżowych. Wyniki. W okresie sześciu miesięcy przed rozpoczęciem badania po leki przeciwbólowe sięgnęło 90% ankietowanych. Kobiety trzykrotnie częściej niż mężczyźni deklarowały, że zażywały leki przeciwbólowe kilka razy w miesiącu. Rodzaj dolegliwości bólowych, w przypadku których respondenci najczęściej stosowali samoleczenie jest zróżnicowany ze względu na płeć, jak również wiek oraz rodzaj aktywności zawodowej badanych. Czynnikiem skłaniającym do zakupu leku przez najstarszych pacjentów jest najczęściej porada farmaceuty (47,1% grupy), a dla najmłodszych – wcześniejsze zastosowanie leku (62,5%). Około 70% badanych przyznaje, że wykorzystuje internet do pozyskania informacji o lekach. Wnioski. Najistotniejszym elementem rozwoju odpowiedzialnego samoleczenia jest edukacja, zarówno w zakresie odpowiedzialnej konsumpcji leków przeciw-bólowych, jak również w zakresie wykorzystywania odpowiednich źródeł dotyczących terapii tych dolegliwości

Genetic evaluation of relationship between mutations in rpoB and resistance of Mycobacterium tuberculosis to rifampin

<p>Abstract</p> <p>Background</p> <p>Rifampin is a first line antituberculosis drug active against bacilli in logarithmic and stationary phase, which interferes with RNA synthesis by binding to bacterial RNA polymerase. Tubercle bacilli achieve resistance to rifampin by accumulation of mutations in a short-81 bp region of the <it>rpoB </it>gene. Among many mutations identified in the <it>rpo</it>B gene, few were verified by molecular genetic methods as responsible for resistance to rifampin (RMP).</p> <p>Results</p> <p>In this study eight different mutations identified in an 81 bp section of a "hot spot" region of the <it>rpo</it>B gene of RMP resistant <it>Mycobacterium tuberculosis </it>clinical strains were evaluated in respect to drug resistance. It was found that: mutations in positions 526 (H/D), 516 (D/V) and 531 (S/L) result in high level resistance to rifampin; mutations in positions 516 (D/Y), 515 (M/I), 510 (Q/H) or a double mutation in codons 512 (S/I) and 516 (D/G) relate to low level of resistance. Gene <it>rpo</it>B carrying mutations in codon 513 (Q/L) introduced into an <it>M. tuberculosis </it>laboratory strain did not cause resistance to rifampin, however the same gene introduced into two different clinical strains did, with the level of resistance depending on the host strain.</p> <p>Conclusion</p> <p>Mutations in an 81 bp "hot spot" region of the <it>rpoB </it>of <it>M. tuberculosis </it>lead to different levels of resistance to rifampin. Some mutations in this "hot spot" region of <it>rpoB </it>require a specific genetic background for the host strain to develop resistance to rifampin. Therefore, the identification of such mutations in a clinical <it>M. tuberculosis </it>strain is not enough to classify the given strain as resistant to rifampin.</p

Wpływ reklamy telewizyjnej produktów leczniczych na zakup przeciwbólowych leków OTC w Polsce

Introduction. Drug manufacturers take a variety of activities to meet the needs of their potential customers. One of the most important elements of drug promotion is advertising. Numerous studies have shown that the most effective form of advertising is television advertising that combines vision with sound, which increases the chance of remembering the advertising.The aim of the study was to point out the relationship between television advertising and purchasing decisions on OTC analgesics among students of Warsaw Medical University.Material and method. The research tool was an anonymous survey. The research was conducted via the Internet.Results. The results showed that television advertising of medicinal products has a significant impact on purchasing decisions among students of Warsaw Medical University. However, students most often suggest the efficacy of the drug while making the decision about purchasing of medicinal product (46.55%). Respondents indicated that the advertising is the most authentic, when the drug is recommended by a doctor. From among all OTC painkillers, students bought mainly headache tablets (90%) and the least often products for bones and joints ache (59.47%).Conclusions. Television advertising is an important promotional tool and a starting point in terms of the impact on potential buyers of drugs. The study shows that television advertising has a significant impact also on the purchase decisions of students. The survey results also indicate that painkillers are one of the most popular categories of medicinal products available without a prescription, which confirms the information published in many reports from the pharmaceutical market, indicating that the consumption of painkillers constantly remains at a high level.Wstęp. Producenci leków podejmują wiele różnych działań, aby zaspokoić potrzeby swoich potencjalnych klientów. Jednym z najważniejszych elementów promocji leków jest reklama. Liczne badania wskazują, iż najskuteczniejszą formą reklamy jest reklama telewizyjna, która łącząc wizję z fonią, podnosi stopień zapamiętywania treści przekazu reklamowego.Celem badania było wykazanie zależności pomiędzy reklamą telewizyjną a decyzjami zakupowymi dotyczącymi leków przeciwbólowych OTC wśród studentów Warszawskiego Uniwersytetu Medycznego.Materiał i metoda. Narzędziem badawczym była anonimowa ankieta, a badanie przeprowadzono za pośrednictwem Internetu.Wyniki. Wyniki badania wykazały, iż reklama telewizyjna produktów leczniczych wywiera istotny wpływ na decyzje zakupowe wśród studentów Warszawskiego Uniwersytetu Medycznego. Podejmując decyzję o zakupie produktu leczniczego, studenci najczęściej jednak sugerują się skutecznością danego leku (46,55%). Respondenci wskazali, że przekaz reklamowy jest najbardziej autentyczny, gdy lek rekomendowany jest przez lekarza. Studencinajczęściej korzystają ze środków przeciwbólowych OTC z powodu bólu głowy (90%), a najrzadziej z powodu bólu kości i stawów (59,47%).Wnioski. Reklama telewizyjna stanowi ważne narzędzie promocji oraz punkt wyjścia w kwestii oddziaływania na potencjalnych nabywców leków. Przeprowadzone badanie wskazuje, iż reklama telewizyjna wywiera istotny wpływ także na decyzje zakupowe studentów. Wyniki badania wskazują również, że leki przeciwbólowe stanowią jedną z najpopularniejszych kategorii produktów leczniczych dostępnych bez recepty, co potwierdza informacje publikowane w wielu raportach z rynku farmaceutycznego, wskazujące, że konsumpcja leków przeciwbólowych stale utrzymuje się na wysokim poziomie

Detection of Giardia intestinalis infections in Polish soldiers deployed to Afghanistan

Background: Members of the Polish Military Contingent (PMC) have been stationed in Afghanistan since 2002. They typically serve in areas characterised by low standards of sanitation which often leads to the development of food- and waterborne diseases. The aim of the study was to evaluate the prevalence of Giardia intestinalis infections among Polish soldiers deployed to Afghanistan. The research study was conducted as part of a programme for prevention of parasitic diseases of the gastrointestinal tract run by the Polish Armed Forces. Materials and methods: The study was carried out in August 2011; it involved 630 asymptomatic Polish soldiers serving in the Forward Operational Base (FOB) Ghazni in eastern Afghanistan. Stool specimens obtained from members of the PMC were first tested in FOB Ghazni (detection of Giardia intestinalis by Rida Quick Giardia immunochromatographic tests and Ridascreen Giardia immunoenzymatic tests — single samples). Next, the same biological material and two other faecal specimens fixed in 10% formalin were transported to the Military Institute of Medicine in Poland, where they were tested for Giardia intestinalis under light microscopy (direct smear, decantation in distilled water). Results: Parasitological tests performed under light microscopy showed that 2.7% (17/630) of the study group were infected with Giardia intestinalis. Some of these results were confirmed by immunochromatographic tests (6/630). In contrast, immunoenzymatic tests (ELISA) demonstrated a significantly higher detection rate reaching 18.1% (114/630). Immunoenzymatic tests confirmed all the positive results given by light microscopy and by immunochromatographic tests. Conclusions: The prevalence rate of Giardia intestinalis infections in Polish soldiers deployed to Afghanistan was found to be high. Microscopic methods exhibit low sensitivity and therefore may result in the underestimation of the true parasite prevalence. Immunoenzymatic tests (ELISA) showing a much higher sensitivity in comparison to light microscopy and immunochromatographic tests ought to be applied in screening for intestinal protozoan infections in areas characterised by harsh environmental conditions.

A systematic analysis of the Polish Code of Medical Ethics

The purpose of this article is to provide a summary of the history which led to the creation of the current structure of the self-regulatory professional body of physicians and dentists, the nature of the professional activities and practice of physicians, as well as an analysis of the legal basis for the adoption of the Code of Medical Ethics. This allows us to draw a series of conclusions as to the influence of the existence of the professional self-regulatory body of physicians on the functioning of the Polish health service

Critical analysis of the Code of Medical Ethics

The wording of this article raises fundamental doubts. Since the physician should also strive of obtain the consent of a minor, the question arises as to who else they should obtain it from? Or in fact who, in the case of a minor, should agree to the provision of healthcare. The main part of this article is a critical analysis of articles of the Polish Code of Medical Ethics