Self-Medication Practice and Their Risk Factors Among BScN 4 Years Students

Self-medication is the use of medicines to treat self-diagnosed disorders or symptoms, or the periodical or continued use of prescribed drugs for acute or chronic disease or symptoms. It’s going to include the use of herbs, the retention and Re-use of Medication without prescribed by doctors. Self-medication is widely practiced in both developed and developing countries. . Practice of getting self-medication was relatively high, because of easy access of drugs from public pharmacy and they also have knowledge about medicines. The study's overall objective was to identify the level of knowledge, attitude, and self-medication practices among undergraduate BScN 4 year student. This would be a descriptive cross sectional quantitative study .Quantitative cross sectional design used data to make statistical inference about nursing students of knowledge, attitude and practice regarding self-medication. Total, 250 BScN students were involved in this study. The data was collected using a validated questionnaire. Overall 53.6% BScN students often practice self-medications,while 46.4% students were not practice self-medications. In a study conducted in a private college of Nursing Lahore, it was found that self-medication is significantly higher in among BScN 4 year’s student nurses. We found that our respondent’s education has also impact on practice and attitude of self-medication. The awareness regarding self-medication among student is good about 60% populations have knowledge regarding medication benefits. As per the findings, 75.8% BScN students visited to a qualified medical practitioner. While 24.2% students were not visited to a qualified medical practitioner. 71.2% BScN students respond that the indications of self-medication Headache/ fever. Inappropriate self-medication can cause harm to the students and also whom they recommend as healthcare providers in the future. Therefore, there is a need to educate nursing students and make them more aware about adverse effects of self-medication. Keywords: Self-care, medical practitioner, nursing Students, Drugs, Self-medication, Knowledge DOI: 10.7176/JNSR/13-18-02 Publication date:October 31st 202

Self-Medication Practice and Their Risk Factors among BScN 4 Years Students

Self-medication is the use of medicines to treat self-diagnosed disorders or symptoms, or the periodical or continued use of prescribed drugs for acute or chronic disease or symptoms. It’s going to include the use of herbs, the retention and Re-use of Medication without prescribed by doctors. Self-medication is widely practiced in both developed and developing countries. . Practice of getting self-medication was relatively high, because of easy access of drugs from public pharmacy and they also have knowledge about medicines. The study's overall objective was to identify the level of knowledge, attitude, and self-medication practices among undergraduate BScN 4 year student. This would be a descriptive cross sectional quantitative study .Quantitative cross sectional design used data to make statistical inference about nursing students of knowledge, attitude and practice regarding self-medication. Total, 250 BScN students were involved in this study. The data was collected using a validated questionnaire. Overall 53.6% BScN students often practice self-medications,while 46.4% students were not practice self-medications. In a study conducted in a private college of Nursing Lahore, it was found that self-medication is significantly higher in among BScN 4 year’s student nurses. We found that our respondent’s education has also impact on practice and attitude of self-medication. The awareness regarding self-medication among student is good about 60% populations have knowledge regarding medication benefits. As per the findings, 75.8% BScN students visited to a qualified medical practitioner. While 24.2% students were not visited to a qualified medical practitioner. 71.2% BScN students respond that the indications of self-medication Headache/ fever. Inappropriate self-medication can cause harm to the students and also whom they recommend as healthcare providers in the future. Therefore, there is a need to educate nursing students and make them more aware about adverse effects of self-medication. Keywords: Self-care, medical practitioner, nursing Students, Drugs, Self-medication, Knowledge DOI: 10.7176/JHMN/104-03 Publication date: November 30th 202

Concentrational study of nutrients related to chelators assisted sunflower (Helianthus annuus L.) from artificially cadmium-contaminated soil

The present study investigates the appliance of cadmium (Cd) noxiousness and damage to nutrient concentration in sunflower hybrids, FH-533 and Hysun-33, as well as the role of natural and synthetic chelator’s oxalic acid (OA) and ethylene triamine tetraacetic acid (EDTA) respectively in reducing the Cd toxicity in sunflower plant. Sunflower, known as heavy metal phytoextractor, was grown in soil artificially contaminated with soluble salt CdCl2 at 250 ppm and 450 ppm. Pot experiment was conducted in a complete randomized design with three replicates for cadmium metal, chelating agents and sunflower hybrids at seedling, vegetative and reproductive stages. Application of Cd of 250 ppm and 450 ppm imposed the negative effect on shoot and root dry biomass by directly or indirectly disturbing the nutrient uptake. Maximum growth and nutrient uptake were observed when chelators (EDTA and OA) were applied alone respectively. In Cd contaminated soil the application of EDTA proved helpful in ameliorating the toxic effect of Cd250 on nutrient content of both sunflower hybrids as compared to Cd450, the Hysun-33 showed better results in terms of K, Ca, Fe, Zn, P, N as compared to FH-533, so it can be cultivated on Cd adulterated soil for better yield. The presented results offer a novel solution for optimization of sunflower cultivation on soil affected by Cd, as well as for increased health-promoting nutrients of sunflower

Primary drug resistance to anti-tuberculous drugs in Karachi

Objective: To assess the frequency of primary drug resistance among newly diagnosed tuberculosis cases in Karachi. Study Design: Cross-sectional study. Place and Duration of Study: Multicentric study involving various TB clinics and treatment centres of Karachi between April to December 2005.Methodology: The frequency of drug resistance among new TB patients was evaluated using a non-probability convenient sampling methodology. Sputum sample was obtained from 140 newly diagnosed sputum smear-positive patients of pulmonary tuberculosis from various centres of Karachi. Sensitivities were performed by proportion method. Results: Fifteen (11.5%) samples in 130 eligible patients showed primary resistance to one or more drugs. Ten (7.6%) of the isolates tested were resistant to a single drug, none were resistant to 2 drugs, 4 (3.0%) to 3 drugs and 1 (0.76%) to 4 drugs while 1 (0.76%) to all 5 first line agents. Resistance to streptomycin (10 ug/ml) was seen in 8 (6.1%), isoniazid (1ug/ml) in 12 (9.2%), Rifampicin (5 ug/ml) in 4 (3.0%), ethambutol (10 ug/ml) in 1 (0.76%) and pyrazinamide in 6 (4.6%) samples. Primary Multi-Drug Resistance (PMDR) was found in 2 (1.5%) patients. (Isoniazid 1 ug/ml, rifampicin 5 ug/ml with or without other drugs). Conclusion: In the studied patients, primary drug resistance to at least one anti-tuberculosis drug was 11.5%. It requires an efficiently working anti-tuberculosis programme to prevent escalation including resistance

Cross-sectional study identifying forms of tobacco used by Shisha smokers in Pakistan

OBJECTIVES: To estimate the frequency of different forms of tobacco intake such as smoker\u27s tobacco, chewable tobacco and snuff tobacco among shisha smoker\u27s and to study the patterns and predictors of shisha smoking affecting youth from different cities of Pakistan. METHODS: A cross-sectional study was conducted including youth from four cities. Participants were asked to fill out a data collection tool at shisha cafes, shopping malls and restaurants. Data was analyzed using SPSSv.18. RESULTS: A total of 406 participants, 296 (73%) males and 110 (27%) females were included in the study. There were 163 (40%) cigarette smokers; 65 (16%) chewed tobacco and 33 (8%) snuffed it. The median age at initiation of Shisha smoking was 20 years. 280 (69%) considered Shisha smoking to be less deleterious to health than cigarettes. Respiratory disease was the most commonly cited health effect reported. Most 248 (61%) of the participants were infrequent shisha smokers. CONCLUSION: There is high frequency of tobacco usage in the form of cigarettes, chewable tobacco and snuff tobacco among shisha smokers of Pakistan. The highest frequency is for cigarette smoking. The rise in Shisha smoking as a trendy social habit appears to be occurring despite emerging scientific evidence of its potential health risks

Long‐term clinical and socioeconomic outcomes of children with biliary atresia

Abstract Background Biliary atresia (BA) is rare liver disease of unknown etiology, and is a major indication for liver transplant (LT). Previous data indicate improved outcomes with early referral for Kasai portoenterostomy (KPE). Objective Evaluate the long‐term outcomes in BA, with particular focus on those transitioned to adult care with native livers. Subjects and Methods Patients with BA treated between1980 and 2012 were identified. Data were collected from the time of referral, transition to adult care, and the most recent clinic notes, from which patient and native liver survival were calculated. Results Four hundred and fifty‐four patients with BA were identified, who were followed up for median of 16.4 years from birth; 74 died (41 of whom had a LT), giving a 20‐year survival rate of 83.6%. Two hundred and seventy‐two patients received an LT, with the median native liver survival being 35 months. Of patients who transitioned to adult care, 54 of 180 (30.0%) retained their native liver. Of these, 72% (39 of 54) had evidence of chronic liver disease at transition, of whom 8 were subsequently lost to follow‐up, 9 were transplanted, and 22 remained stable with compensated liver disease. Of the 15 of 54 patients (28%) with no evidence of chronic disease in their native liver disease at transition, 3 were subsequently lost to follow‐up; none received transplants, although 3 patients developed new‐onset liver disease. All patients transitioned to adult care completed secondary school education (N = 180), with 49% having attended college/university and 87% being in employment or education at the last follow‐up. Of female patients, 34% had at least one pregnancy (27 children in 21 women), while 22% of males had fathered a child. Conclusion Long‐term outcomes in BA are good, with patients surviving into adult life. Progression of chronic liver disease and associated morbidity is common in those who retained their native livers, suggesting that these patients require monitoring of liver disease throughout adult life, and early recognition of the need for LT

An unusual variant of choledochal cyst: a case report

<p>Abstract</p> <p>Introduction</p> <p>Choledochal cyst is an uncommon congenital disease of the biliary tract in the UK. There are five main types of choledochal cyst with several recognised sub-types. However, occasional variants do occur.</p> <p>Case presentation</p> <p>We report a case of a female infant with an antenatally diagnosed choledochal cyst. The operative cholangiogram revealed an unusual intrahepatic biliary tree. The cyst was successfully excised and the infant is well at 18-months follow up.</p> <p>Conclusion</p> <p>The anatomy should be clearly defined before surgical excision as abnormal variants can occur, which usually do not fit into the known classification types and subtypes.</p

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability