Medical Dispensary Research Articles

EMERGENCIES IN THE PRACTICE OF MEDICAL DISPATCHING IN POLAND. CHALLENGES IN THE COOPERATION OF EMERGENCY MEDICAL TEAMS WITH MEDICAL DISPATCHERS

The article presents the organization of The State Emergency Medical System in Poland in terms of the operation of the medical dispensaries. Particular attention was paid to the cooperation of medical dispatch centers with Emergency Medical Teams (EMTs) in the realities and circumstances of unexpected events. Areas requiring increased attention during an emergency involving medical dispensary systems have been highlighted. Incidents involving, in particular, various types of unavailability of ICT systems are included. These situations make it necessary to change the daily way of working. Due to the differences in professional practice that apply to those who perform their tasks within the framework of medical rescue teams and medical dispatchers, such circumstances may cause a discrepancy in the understanding of the above-mentioned issue. Given the current tense geopolitical situation and the military conflict beyond Poland's eastern border, special attention should be paid to the possibility of destabilizing the ICT domain in terms of the country's internal security systems. Active local exercises, but also those covering larger areas of the country, will allow to verify the current ways of doing things, the availability of emergency kits and alternative solutions. Above all, however, this will be the only opportunity to learn from non-harmful contingencies that will enable the smooth operation of Poland's prehospital healthcare system during the challenges ahead.

Experience of strategic sessions to improve the quality of lean technology implementation in medical organizations in Krasnodar Krai: a one-stage observational study

Background. Lean production is mainly focused on increasing value in processes and improving the quality of services provided. These principles are implemented in medical organizations within the framework of the national project “Healthcare” and the federal project “Development of the Primary Healthcare System”. Introduction of lean technologies at all levels of the organization can serve as a highly effective method of positive changes. In 2023, Kuban State Medical University, together with the Ministry of Health of Krasnodar Krai and the Regional Center for Primary Healthcare, held a strategic session aimed at identifying problematic processes in medical organizations of the region and jointly searching for ways to solve them. The session involved 73 primary healthcare organizations. Its results formed the basis for a study of the project activity of medical organizations. Objective. To analyze the current state of project activities of medical organizations in Krasnodar Krai to achieve a “new model” through the introduction of lean technologies.Methods. A one-stage observational study was carried out in two steps. The first step involved participant observation. Its results determined a set of tools to be compiled. The second step of the study included a questionnaire survey and analysis of information. The data obtained from the questionnaire survey and observation were coded, the distribution and frequency were identified using frequency analysis and calculation of mean values. The qualitative analysis of open-ended questions was additionally applied.Results. The analysis showed that the prevailing number of projects are aimed at forming and developing the availability of medical care for the population (50.6 %), including projects focused on inclusiveness and provision of medical care to low-mobility patients at home. It was also revealed that 42 projects in four areas are planned for implementation in 47 organizations using lean technology tools in 2024. The study showed that 91.49 % of projects failed to calculate financial efficiency and evaluate project results in monetary terms. Meanwhile, 8.51 % of those who carried out the efficiency calculations lacked an analysis methodology and revealed the superficiality of the calculations. Of all the participants, 53.19 % reported the need for help in organizing and implementing project activities, and 36.17 % of the participants had enough resources to cope on their own. The three most problematic processes requiring joint work with colleagues included “Reducing the wait times for healthcare in regional medical organizations,” “Registration of discounted prescriptions” and “Preventive medical examination and dispensary.”Conclusion. The experience of a strategic session at Kuban State Medical University proved to be effective in improving the quality of implementation of lean technologies in medical organizations of Krasnodar Krai. The study was instrumental in assessing the current state of the project activities of medical organizations to achieve a “new model” through the introduction of lean technologies, as well as in identifying the most common areas of project activities and the main problems. The performed analysis revealed a positive trend in improving the quality of work of medical organizations in Krasnodar Krai and disseminating the lean technologies in primary healthcare.

REFERENCE OF CITIZENS TO THE MEDICAL AND LABOR PROPHYLACTORY ON THE WAY OF REALIZING CONSTITUTIONAL VALUES: EFFECTIVE PREVENTION OR IMPROPER PRACTICE?

It is indicated that, from the point of view of the author, there are problematic issues in legal practice in civil cases regarding the direction of citizens to a medical and labor dispensary. Based on the provisions of the Constitution and other normative legal acts of the Republic of Belarus, the leading positions of the legal doctrine, judgments are derived that prove the fallacy of the general direction of national judicial practice in cases of the category under study and substantiate the need for its further improvement. A conclusion is made about the unconstitutionality of the provisions of the previous legislation as a result of their actual obstacles to the realization of the rights and freedoms of the individual as the highest constitutional values. The special role of the Constitutional Court of the Republic of Belarus in the protection and defense of the latter is emphasized. Problems are found and their consequences are given, caused by misinterpretation and application of legal norms, legal conflicts and incompleteness of legal regulation. Amendments to the legislation, correction of law enforcement practice in cases under consideration are proposed.

Features of the health state of persons of the special medical group of higher education institutions of the city of Dnipr

The results of the study of the state of health of students of the special medical group of institutions of higher education in the city of Dnipro for the period 2017-2019 are given. Establishing regional trends in the state of health of students is extremely important, because in addition to national ones, it is necessary to create appropriate action programs at the local level, as well as level of individual institutions of higher education.
 It is shown that the distribution of students of higher education institutions in 2017-2019 by health groups was quite stable. In 2017, 80.50% of those examined were classified as D1 (healthy), in 2018, 79.80%, and in 2019, 84%. Group D2 (practically healthy) - 7.10%, 7.20% and 6.20% of students, respectively. To D3 (special medical group) - 7.40%, 7% and 5.80% of the examined. 5%, 6% and 4% are among those who are exempted from practical physical education classes.
 The following was established regarding the diseases of students of Dnipro institutions of higher education in 2017-2018: according to the medical and physical culture dispensary: in all institutions of higher education for two years, the same diseases occupied a prominent place. The first place is diseases of the cardiovascular system, 17.6% in 2017 and 20.3% in 2018. The second place is neurological diseases (without mental diseases) 16.3% and 17.2%. The third place is diseases of the musculoskeletal system, 13.8% and 14%, respectively.

The effects of the 4/20 cannabis holiday and adult-use cannabis legalization on medical cannabis sales and medical cannabis patient registration in Arizona.

This study examined whether the 4/20 cannabis holiday was associated with increases in medical cannabis sales from licensed dispensaries in Arizona from 2018-2021, and whether adult-use cannabis legalization (the vote in November 2020 and retail sales in January 2021) was associated with declines in medical cannabis sales and in the number of registered medical patients. Data came from the Arizona Medical Marijuana Program monthly reports from January 2018-December 2021. The reports show daily sales from licensed medical cannabis dispensaries (i.e., the number of medical cannabis dispensary transactions and the amount of cannabis sold in pounds), which we averaged by week, and show the number of registered medical cannabis patients each month. Autoregressive integrated moving average models were used to test changes in these outcomes associated with the 4/20 cannabis holiday and with legalization of adult-use cannabis. During the week of the 4/20 cannabis holiday, medical cannabis dispensary transactions abruptly increased by an average of 2,319.4 transactions each day (95% CI: 1636.1, 3002.7), and the amount of medical cannabis sold increased by an average of 120.3 pounds each day (95% CI: 99.3-141.3). During the first week of adult-use cannabis sales in late January 2021, medical cannabis dispensary transactions abruptly decreased by an average of 5,073 transactions each day (95% CI: -5,929.5, -4216.7), and the amount of medical cannabis sold decreased by an average of 119.1 pounds each day (95% CI: -144.2, -94.0). Moreover, medical cannabis sales continued to gradually decline each week after the start of adult-use retail sales, with declines in sales preceding declines in registered patients. By December 2021, slightly over a year after the vote to legalize adult-use cannabis, the actual number of registered medical cannabis patients fell short of the forecasted number, had adult-use not been legalized, by 36.5%. Moreover, the number of medical dispensary transactions and the amount of medical cannabis sold fell short of expectations, had adult-use cannabis not been legalized, by 58% and 53%, respectively. Findings document the blurred boundary between medical and non-medical cannabis use and are consistent with the possibility that medical cannabis legalization contributes to increases in adult cannabis use and dependence.

ВЗАИМОСВЯЗЬ ОЦЕНКИ САМОАКТИВАЦИИ С ВОЛЕВОЙ САМОРЕГУЛЯЦИЕЙ И ТИПОМ МЕЖЛИЧНОСТНЫХ ОТНОШЕНИЙ ЗАВИСИМЫХ ОТ АЛКОГОЛЯ ЛИЦ

Background. The process of psychotherapy of alcohol-addicted persons becomes effective through understanding the relationship between self-activation motives, the state of self-regulation and their social functioning. Purpose: To study the relationship between the assessment of self-activation, volitional self-regulation and the types of interpersonal relationships in alcohol-dependent persons in order to determine therapeutic «targets» for a targeted impact on dependent constructs in the process of psychotherapy. Material and methods. The study was conducted on the basis of the medical and labor dispensary (LTP) No.5 of the Ministry of Internal Affairs of the Republic of Belarus. A total of 250 men aged 24 to 60 years were examined. Group I included persons with alcohol dependence syndrome, who while in the LTP setting, underwent psychotherapy for persons with alcohol dependence syndrome (150). Group II consisted of persons with alcohol dependence syndrome, who while in the LTP setting, participated in the standard program of medical and social readaptation (100). The following psychodiagnostic methods were used: test questionnaire «Research of volitional self-regulation»; BIS/BAS questionnaire; the technique «Diagnostics of interpersonal relations». Results. The results of assessing the type of interpersonal relationships, volitional self-regulation and sensitivity to positive and negative stimuli did not reveal statistically significant differences between the groups (p>0.05). We identified weak positive relationships in people of group I between «Perseverance» on the BAS scale and the type of relationship «Selfish», «Aggressive», «Suspicious», «Dependent» (p<0.01); between «Pleasure seeking» on the BAS scale and «Authoritarian» (p<0.01), between «Pleasure seeking» on the BAS scale and «Aggressive», «Suspicious», «Dependent» (p<0.01); between BIS and «Suspicious», «Subordinate», «Dependent», «Friendly», «Altruistic» (p<0.05). Weak negative relationships were identified in people of groups I and II between the BIS scale and the scale of volitional self-regulation «Persistence», «General level of volitional self-regulation» (p<0.05). We also identified weak negative relationships in people of group I between the «Self-control» scale and BAS «Persistence», BAS «Pleasure seeking», BAS «Reactivity» (p<0.01); between BAS «Persistence» and BAS «Search for pleasure» and the scale «General level of volitional self-regulation» (p<0.01). Conclusion. The obtained data of relationships made it possible to take into account the dual nature of the selfactivation system and include an intermittent sequence in the process of psychotherapy: the importance of emotional support experience (BAS), leveling and reshaping of negative experience (BIS), reassessment of the subjective significance of one's own personality with the activation of awareness and constructive choice of effective sobriety tools (BAS), the development of a system to counter dependent stimuli and challenges (BIS), the integration of the value of sober thinking into the life system (BAS).

Impact of cannabis legalization on healthcare utilization for psychosis and schizophrenia in Colorado.

Emergency department (ED) visits involving psychosis and schizophrenia have increased at a rate exceeding population growth in the United States over the past decade. Research shows a strong dose-response relationship between chronic use of high-potency cannabis and odds of developing symptoms of psychosis. The aim of this study was to evaluate the impact of cannabis legalization on psychosis and schizophrenia-related ED visits in Colorado. Using administrative data from Colorado Hospital Association (CHA) on county-level quarterly ED visits between January 1, 2013, and December 31, 2018, we applied a difference-in-difference analysis to examine how new exposure to recreational cannabis dispensaries after 2014 differentially influenced the rate of ED visits for psychosis and schizophrenia, comparing counties with no prior medical cannabis dispensary exposure to counties with low or high medical dispensary exposure. As recreational dispensaries per 10,000 residents increased, there was no significant association with the rate of schizophrenia ED visits per capita (incidence rate ratio or IRR: 0.95, 95% CI [0.69, 1.30]) while the rate of psychosis visits increased 24% (IRR: 1.24, 95% CI [1.02, 1.49]). Counties with no previous medical dispensaries experienced larger increases in schizophrenia ED visits than counties already exposed to a low level of medical dispensaries, but this effect was not significant. Counties with low baseline medical exposure had lower increases in rates of psychosis visits than counties with high baseline medical exposure (IRR 0.83, 95% CI [0.69, 0.99]). There was a positive association between the number of cannabis dispensaries and rates of psychosis ED visits across all counties in Colorado. Although it is unclear whether it is access to products, or the types of products that may be driving this association, our findings suggest there is a potential impact on the mental health of the local population that is observed after cannabis legalization.

Epidemiology and Prevalence of Oral Candidiasis in HIV Patients From Chad in the Post-HAART Era.

Oral candidiasis remains a common problem in HIV-infected individuals, especially in sub-Saharan Africa. Here, we performed the first study in Chad on the prevalence of oral yeasts carriage and oral candidiasis in HIV-positive subjects from southern Chad and analyzed the influence of HAART, CD4+ T-cell numbers, and antimycotics in 589 patients. These patients were recruited from a specialized medical center for HIV patients in Sarh and from a rural medical health dispensary in the vicinity, including a total of 384 HIV-positive and 205 HIV-negative individuals. Yeasts obtained from oral specimen were identified by MALDI-TOF MS and their antifungal susceptibility profiles determined. The overall prevalence of yeast colonization and symptomatic oral candidiasis in HIV-infected patients was 25.1%. The prevalence of oral candidiasis was higher in untreated than in HAART-treated HIV-positive patients (16% vs. 2%; p < 0.01). Oral candidiasis was furthermore associated with high fungal burdens of Candida albicans and a CD4+ T-cell number <200/μl. A shift toward non-albicans Candida species was observed under nucleoside-based HAART therapy. Azole antifungal drug resistance was only observed for the intrinsically resistant species Candida krusei and Candida glabrata. Prevalence of oral candidiasis in the studied area was very low. The species distribution was similar to other countries around the world, with C. albicans being dominant. Candida dubliniensis was not isolated. Nucleoside-based HAART therapy significantly reduced oral colonization as well as occurrence of oral candidiasis caused by C. albicans and led to a species shift toward non-albicans species. Antifungal resistance was not yet a concern in Chad.

Experience in organizing exercise therapy service in the Republic of Bashkortostan

The history of the development of sports medicine is closely connected with the growth and development of physical culture and sports. At the end of the 40s, medical control took shape as a state system of medical support for physical education and sports, and in 1951 the Ministry of Health of the USSR issued an order on the organization of medical and physical education dispensaries. They began to open in all the republics of the USSR, regions, large cities and districts of Russia. In November 1952, the Republican Medical and Physical Education Dispensary was organized in the Republic of Bashkortostan, Ufa. The authors of the article share their experience in organizing the medical and physical education service of the Republic of Bashkortostan at the present stage.

Changes in Emergency Department Encounters for Vomiting After Cannabis Legalization in Colorado

Cannabis hyperemesis syndrome is an emerging clinical issue associated with cannabis use. Legalization of cannabis has led to an increase in vomiting-related illnesses in health care settings. To examine whether legalization of cannabis in Colorado has been associated with increases in vomiting-related emergency department (ED) visits. A cross-sectional design was used to assess the increase in ED claims for vomiting reported to the Colorado Hospital Association between January 1, 2013, and December 31, 2018, in counties that had no prior cannabis dispensaries before legalization compared with those that did. A total of 820 778 patients seeking care through Colorado EDs were included in the analysis. The number of medical and recreational cannabis dispensaries per county per quarter. County per capita rate of vomiting-related ED claims per quarter. Vomiting-related ED health care encounters increased from 119 312 in 2013 to 153 699 in 2018 (29% increase). Over this period, 203 861 patients (25%) were aged 0 to 18 years; 114 201 (14%) were aged 19 to 25 years, and 502 771 (61%) were aged 26 years or older; 510 584 patients (62%) were female. Additional recreational dispensaries were associated with increased vomiting-related ED visits (incidence rate ratio, 1.03; 95% CI, 1.01-1.05), but counties with high baseline medical dispensary exposure experienced smaller increases in vomiting-related ED visits than counties with no baseline medical dispensary exposure (incidence rate ratio, 0.97; 95% CI, 0.95-0.99). Counties with a high number of medical marijuana dispensaries had increases at a 5.8% slower rate than counties with none. The findings of this study suggest that cannabis legalization in Colorado is associated with an increase in annual vomiting-related health care encounters with regard to exposure to these markets. It may be useful for health care clinicians to be aware of cannabis hyperemesis syndrome and inquire about cannabis use when appropriate.

New momentum in exploring marijuana's medical benefits: Marijuana has been lauded and lambasted for its potential effects on the body. In part 1 of a 2-part series, we investigate the accumulating evidence for the effectiveness of cannabis in treating some medical conditions.

New momentum in exploring marijuana's medical benefits: Marijuana has been lauded and lambasted for its potential effects on the body. In part 1 of a 2-part series, we investigate the accumulating evidence for the effectiveness of cannabis in treating some medical conditions.

Criteria for assessing the level of physical fitness and physical state of football players with cerebral paralysis, taking into account their sports classes

Background and Study Aim. The article is devoted to finding ways to optimize the training of players with cerebral palsy (CP). It is determined that testing and elaboration of criteria for assessing the level of physical fitness of football players with cerebral palsy can be used as a mean of evaluation the sportsmanship of football players of this nosology in training and competitive activities. The purpose of the study is to determine the level of physical and functional preparedness of football players with cerebral paralysis and to develop criteria for their evaluation during the intensive training period, taking into account the functional classes of athletes.&#x0D; Material and Methods. 25 football players with cerebral palsy, candidates and members of the national team of Ukraine, three-time Paralympic champions, multiple world and European champions took part in the study voluntarily. Athletes of the selected group have 5-8 classes of the adapted classification of the International Association of Cerebral Palsy (CP-ISRA) for CP-Football. Biochemical parameters were studied before and after training work of different focus. The value of maximum oxygen consumption (MOC) was determined by means of bicycle ergometric testing. The physical state and level of physical fitness of football players were monitored during the study. The research was conducted on the basis of the research laboratory of Prydniprovsk State Academy of Physical Culture and Sport and on the basis of the Municipal Institution "Dnipropetrovsk Medical and Physical Dispensary" of the Dnipropetrovsk Regional Council.&#x0D; Results. It was found that athletes with cerebral paralysis are able to adequately tolerate heavy physical loads. Football players with disabilities had biochemical parameters of blood sampling and registration of recovery processes of the cardiovascular system after training activities of different focus within the permissible norm for both healthy athletes. Obtaining such data became the basis for the intensification of training process, which promoted the development of motor skills of football players.&#x0D; Conclusions. Obtained data were the basis for creation the criteria for assessing the level of physical fitness of football players depending on their sports classes. In future, this will allow coaches to determine the effectiveness of the training period, obtain information about the condition of players in training, in the recovery process. On this basis it will help to individualize the workload of players and adjust the training process. The analysis of a direction of preparation and decision-making about educational process correction for football players with disabilities can be realized according to the received data in various structural formations of an annual macrocycle.

Comparing older nonmedical and medical cannabis users: health-related characteristics, cannabis use patterns, and cannabis sources

ABSTRACT Background: US epidemiologic data show that nearly one in 10 individuals aged 50+ report past-year cannabis use, and nearly one in five users report medical use. However, research on older cannabis users, especially medical cannabis users, is scant. Objectives: We examined medical and nonmedical cannabis users aged 50+ on health-related characteristics, cannabis use patterns, and cannabis sources. Hypotheses were that compared to nonmedical users, medical users are more likely to have physical and mental health problems, use healthcare services, discuss their drug use with a healthcare professional, use cannabis more frequently, and purchase cannabis from a medical dispensary and other sources rather than obtain it as a gift, share someone else’s, or use other means. Methods: We used 2018 and 2019 National Survey on Drug Use and Health data (N = 17,685 aged 50+; male = 8,030; female = 9,655). Hypotheses were tested using logistic regression analysis. Results: The past-year cannabis use rate was 8.9%. Of past-year users, 18.5% reported medical use. Compared to nonmedical use, medical use was associated with lower odds of alcohol use disorder but higher odds of discussing drug use with a healthcare professional (AOR = 4.18, 95% CI = 2.53–6.89), high-frequency use (e.g., AOR = 2.56, 95% CI = 1.35–4.86 for 200–365 days), and purchase at a medical cannabis dispensary (AOR = 4.38, 95% CI = 2.47–7.76). Conclusion: Medical and nonmedical users did not differ on physical and most behavioral health indicators. Most obtained cannabis from private/informal sources. Some medical users are likely to self-treat without healthcare professional consultation. Healthcare professionals should engage older adults in discussions of cannabis use and behavioral health needs.

ОРГАНИЗАЦИОННЫЕ ПРОБЛЕМЫ ДИСПАНСЕРНОГО НАБЛЮДЕНИЯ ЗА ЛИЦАМИ, ЗАНИМАЮЩИМИСЯ ФИЗИЧЕСКОЙ КУЛЬТУРОЙ И СПОРТОМ, В РЯЗАНСКОЙ ОБЛАСТИ

The article is devoted to the organizational aspects of the activity of the Ryazan regional medical and physical culture dispensary for the medical support of the population engaged in physical culture and sports. Specially emphasized is the need to modernize medical support of people engaged in physical culture and sports in the Ryazan region, which is determined by a significant imbalance between the increasing burden on the specialists of the medical and physical culture dispensary and the high rate of commissioning of new sports facilities, and, as a result, a significant increase in the number of people engaged in physical culture and sports. The real costs of working time of specialists were determined, which made it possible to develop and realize a plan of measures aimed at reduction of the time of direct examination by a doctor, the time spent by athletes at the examination stage and, accordingly, increasing their number per unit time. Conclusion. The reasonability of optimization of the structure of the medical and physical culture dispensary of the Ryazan region, development of methods for planning its activities, formation of a unified concept of sports and wellness medicine within the framework of the preventive direction with the creation of a branch development program is identified, which will improve both the quality of medical care provided at the outpatient stage, and will result in reduction of morbidity, probability of sudden death, and of cases of premature retirement from sports.

Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study

ObjectiveTo examine county level associations between the prevalence of medical and recreational cannabis stores (referred to as dispensaries) and opioid related mortality rates.DesignPanel regression methods.Setting812 counties in the United States...

The current state of the medical and physical education service in Ryazan region: The main trends and ways of development

Study objective : to analyze the activities of the regional Ryazan medical and physical dispensary in health maintaining and promoting in various medical and social groups and identify ways to improve the dispensary medical services quality. Materials and methods : a timing study of specialists, registry and laboratory workers involved in an in-depth examination at the medical exercises dispensary in Ryazan region. The 14-day study involved 20 specialists and 50 patients who underwent an in-depth medical examination. Results: We identifies the specialists working time consumption to develop and implement an action plan to reduce medical visit duration, the time spent by athletes at the examination stage and, accordingly, to increase the institution capacity. Conclusion s: there is an obvious need to modernize medical support for people involved in physical culture and sports in the Ryazan region due to a significant lag in the growth rates of physiotherapy and sports medicine services from the rate of new sports facilities are commissioned and a significant increase in the number of athletes involved in physical culture and sports.

Down and Out in Saigon: Stories of the Poor in a Colonial City. By Haydon Cherry (New Haven, Yale University Press, 2019) 280 pp. $50.00

<i>Down and Out in Saigon: Stories of the Poor in a Colonial City</i>. By Haydon Cherry (New Haven, Yale University Press, 2019) 280 pp. $50.00

ANALYSIS OF THE DYNAMICS OF THE NUMBER OF VETERANS WHO ACCOMPLISHED IN THE INVENTORY

The need to address the issues of treatment and dispensary accounting for war veterans and combatants is one of the most pressing issues that has received considerable attention. Events that have taken place in the distant past and that have taken place in recent years in the east of our country before, excite everyone and compel our authorities and health care organizers to develop inpatient care, dispensary surveillance and rehabilitation programs for war veterans and combatants actions. The multifaceted delivery of medical assistance and dispensary to war veterans and combatants requires the effective functioning of this system as an independent area of clinical and social medicine.&#x0D; Military action is always accompanied by casualties and injuries to both military and civilians. Persons in poor health as a result of military action, which is expressed in restriction on military service or work, need to move first and foremost to establish a permanent disability. This is due to the fact that the disability structure identifies a group of causes, including people who have completely or partially lost their disability as a result of injury, injury or injury sustained during their military service.&#x0D; Surveys of war veterans and combatants take place in outpatient clinics and, under certain circumstances, may be carried out by a visiting team of specialists to the field (hospitals, rural dispensaries, FAPs, and veterans' homes). In health care facilities, veterans' examinations are carried out at their previous call. War veterans are inspected at home by a visiting team of specialists in cases where they live far away from health care facilities and because of their health, and cannot be examined.&#x0D; Introduction. The issue of inpatient treatment of combatants and war veterans is one of the topical issues that is receiving considerable attention and is being addressed by meetings of governmental committees and civic organizations. The main goal in addressing these issues is to restore the physical and mental health of participants in the hostilities, achieve social and psychological well-being, reduce the frequency and severity of the effects of mental traumas suffered in the form of acute stress reactions, prevention of disability, prevention of aggression and prevention of aggression.&#x0D; Dispensary observation is a complex of medical measures, which is based on active, constant monitoring of the state of human health, detection of diseases in the early stages, detailed research, study, and elimination of the causes of their occurrence, carrying out medical and health, sanitary, social and hygienic activities aimed at improving the environment, work and people's lifestyles. Fast and quality treatment, effective medical rehabilitation, dispensary observation can only be achieved with early onset, continuity, consistency, continuity and completeness of medical care for patients, individual approach and programming of rehabilitation, timely rehabilitation.

Differences between medical and recreational cannabis

Every state has its own process for regulating legal cannabis, but we have been particularly interested in Massachusetts, which has a carefully structured process for regulation of both medical (established in 2013) and the recently approved recreational dispensaries — we visited a medical dispensary recently (see ADAW, June 24).

Consumption pattern of gabapentinoids in a tertiary health-care system: a five year study from 2012-2017

Background: Treating chronic pain has always been a great challenge for the treating physician. As the available pharmacotherapy do not always yield desired results, wider armamentarium is needed in tackling the chronic pain. Hence gabapentinoids are often considered, but it has led to widespread off label use of these groups of medications. Hence a study of consumption pattern was carried out to assess the usage of gabapentinoids.Methods: The consumption pattern of gabapentinoids (gabapentin/ pregabalin/ any combination) was recorded from the medical stores and dispensary of tertiary care teaching hospital.Results: There is an upward trend in the usage of all gabapentinoids between 2012 to 2017 and pregabalin was seen to be the commonly used gabapentinoid. In the recent years apart from individual gabapentinoids there is a trend favoring use of FDCs of gabapentinoids with nortryptyline and methylcobalamine.Conclusions: The increase in the usage pattern should alarm us to look into the off label uses of gabapentinoids. As there is a possibility of abuse and misuse of gabapentinoids clear guidelines regarding the same is the need of the hour.