Qualified Medical Practitioner Research Articles

Prevalence and pattern of use of medications amongst undergraduate students of a Nigerian University

University undergraduates in Nigeria use prescription and over-the-counter (OTC) medications for cognitive enhancement and relaxation during examination periods. Such practices can lead to increased toxicity, drug interactions, and other adverse effects. This study investigated the prevalence and pattern of use of prescription and OTC medications amongst undergraduate students at the University of Lagos. Quantitative data were collected from 386 students in 2018. The collected data was analysed using SPSS version 22. The study found that 68% of respondents frequently used prescription and OTC medications, such as non-medical analgesics, caffeine-containing drugs, cough syrups containing codeine, diphenhydramine combinations, bromazepam, antimalarials, and antibiotics, during the examination period. The medications were accessed through community pharmacies and leftover medications at home. The findings highlight the ease of access to these medications as a major contributor to their non-medical use by students. This suggests the need for legislation and a functional regulatory framework to control the sale of medications without a prescription from a qualified medical practitioner and sustained public awareness campaigns on medication use and the potential danger of self-medication.

Comparative analysis of psychotherapy services and reimbursement mechanisms across European countries

Introduction. Mental health services and access to psychotherapeutic assistance are vital components of comprehensive healthcare systems. However, the implementation and reimbursement of psychotherapy vary significantly across European countries. Understanding these variations is essential for policymakers, healthcare providers, and mental health advocates to ensure equitable and effective mental healthcare services throughout the continent. Methods. This article presents an in-depth analysis of psychotherapy landscapes in several European countries, focusing on eligibility criteria, coverage models, and reimbursement mechanisms. The countries under consideration include Switzerland, Finland, Denmark, Sweden, Norway, Netherlands, Germany, France, Belgium, Austria, Bulgaria, Croatia, Greece, Poland, and Italy. Results. Each country has developed a unique system for delivering mental health services, resulting in diverse approaches to psychotherapy provision. The common trend across many nations is the requirement for psychotherapy to be prescribed or recommended by a qualified medical practitioner, often involving initial free or subsidized sessions with the possibility of extension contingent on evaluation. Eligibility criteria for free or subsidized psychotherapy often depend on factors such as the severity of the condition and specific diagnosis. Challenges related to access, including long waiting lists, are evident in some countries, leading individuals to seek private sessions to overcome delays. The division between public and private practice creates potential fragmentation in mental health care delivery. Conclusion. Access to psychotherapy in Europe is a complex landscape with each country adopting a unique approach. Ongoing challenges include availability, cost, and recognition of diverse therapeutic approaches. Standardizing mental health services across Europe is crucial for addressing these challenges and ensuring individuals receive the necessary support. Efforts are needed to improve accessibility, affordability, and recognition of various psychotherapeutic modalities to enhance mental healthcare services continent-wide.

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 30 th 2022

Formation of FIQH Parameters for Treatment Using Platelet-Rich Plasma (PRP)

The platelet-rich plasma (PRP) treatment is a method of medical treatment using sources from processed human blood. The process is intended to isolate PRP from human blood. It is a component of blood plasma that is enriched with platelets. Platelets are small blood cells that contain more than 30 bioactive proteins that play an important role in the process of blood clotting and tissue healing. Since the PRP method is a treatment that uses sources of human blood for the purpose of treatment whether aesthetic or therapeutic treatment, it certainly requires a thorough study of fiqh for its use. Islamic law advises its followers to strive to treat any illness or reduce the pain experienced by a person. However, every treatment used including PRP treatment, is still subject to the control of the principles of Islamic law to ensure that the treatment is not contradicting with Islamic law. Thus, this study was conducted using a qualitative method based on the method of library research and interviews to produce a fiqh parameter for PRP-based treatment. The results of the study concluded that three principles in the formation of these parameters need to be examined, namely; (i) parameters for determining the validity of masyaqqah, (ii) parameters for adverse effects of the disease on patients and (iii) parameters for determining the types of items that are prohibited (muharramat). Therefore, treatment using the PRP whether treatment for aesthetic or therapeutic purposes must comply with the details in all the relevant parameters as the method of treatment cannot be permitted totally. In addition, PRP treatment should also be recommended by a qualified medical practitioner and implemented according to proper procedures to avoid the risk of side effects towards patients

Pharmacists' Knowledge, Attitude and Practice Regarding the Dispensing of Antibiotics without Prescription in Tanzania: An Explorative Cross-Sectional Study.

Inappropriate use of antibiotics has been reported to contribute to the emergence and increase of antimicrobial resistance (AMR) in the world. The pharmacist has the responsibility to supervise the dispensing of antibiotics with prescriptions to ensure rational use. An online semi-structured questionnaire was shared with approximately 1100 licensed pharmacists in Tanzania. Study data were collected and managed using REDCap electronic data capture tools before use for analysis. Of the 226 (20.5%) received responses, 197 had given consent and provided complete surveys. Notably, 153 (77.7%) of the 197 pharmacists had excellent knowledge about the legal requirements for dispensing antibiotics and the AMR challenge. Of the 197 surveyed pharmacists, 143 (72.6%) admitted to dispensing antibiotics without a prescription in their daily practice. Notably, 84.1% (37/44) of pharmacists with masters or PhD education were more likely to dispense without a prescription compared to 69.3% (106/153) among bachelor holders (p-value = 0.04). The reasons for administering antibiotics without a prescription included the pharmacy business looking for more profit, patient failure to obtain a prescription and the lack of stringent inspection of pharmacies by the regulatory authorities. Penicillins, macrolides and fluoroquinolones were the classes of antibiotics most commonly dispensed without a prescription. Stringent inspections by the regulatory authorities should detect and reduce dispensing antibiotics without a prescription. The community should be educated on the importance of medication prescription from a qualified medical practitioner.

Red flag rules for knee and lower leg differential diagnosis.

Physical therapists can be frequently a patient's initial encounter after a lower extremity injury, as access to physical therapy services have become readily available without a physician's referral. In 2017, over 65% of physical therapy providers are treating via direct access in United States that allow unrestricted access. In addition to direct access, in an age when at least one of four Americans have multiple chronic medical conditions, it is vital to be able to perform a comprehensive examination, which includes a thorough patient history, systems review, and objective test and measures. Physical therapists should identify red flag symptoms and signs indicating possible pathological condition(s). Based on the findings, a clinical decision should be made to either treat the patient, refer the patient to an appropriate healthcare practitioner, or initiate both treatment and referral. If serious pathology is suspected, it is most prudent to refer the patient appropriately to a qualified medical practitioner.

USAGE OF INTERACTIVE EDUCATION METHODS DURING INTERNAL MEDICINE TEACHING OF 6-YEAR STUDENTS

The aim of the work is to analyze interactive education methods during internal medicine teaching of 6-years students of the Faculty of Medicine.
 Main body. The training of a physician in modern conditions has to correspond as to the problems of health care, as well to society at large, upon that a modern physician has to be not only competent in the area of their restricted professional tasks, but also to be well-versed in questions of diagnostics and treatment, basics of evidence-based medicine, to stay tuned in interdisciplinary branches. Quality of medical education will influence quality of medical aid in Ukraine.
 Conclusion. Introduction of interactive education techniques will enable to get a high qualified medical practitioner in the future.

Factors associated with retention of community health workers in maternal, newborn and child health programme in Simiyu Region, Tanzania.

BackgroundAttrition of community health workers (CHWs) continues to threaten the full realisation and sustainability of community-based health programmes globally.AimThis study aimed to understand factors associated with CHWs’ recruitment and their retention.SettingThis study was conducted in five districts of the Simiyu Region, namely, Bariadi, Busega, Itilima, Maswa and Meatu in north-western Tanzania.MethodsIn this cross-sectional study design, 341 CHWs who were working with the maternal health programme were randomly selected. Semi-structured questionnaires were administered to all participants. Data were descriptively and inferentially analysed using SPSS version 20.ResultsMajority (58.0%) of CHWs were below 35 years. Over half (53.1%) had completed primary education only. Motivation factors for being CHW were aspiration to serve the community and desire for further training to become a qualified medical practitioner. Community recognition and financial incentives were among the key retention reasons for the CHWs. Being married (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.7–20.1) having prior volunteer experience (OR 10.5 95% CI 12.7–40.5) and prior employment OR 21.8 (CI 12.2–38.9) were positively associated with retention of CHWs, while being a female was negatively associated with retention OR 0.4 (CI 0.2–0.8).ConclusionsBoth financial and non-financial incentives were critical in contributing to the retention of CHWs. Thus, health programmes should carefully select CHWs by understanding their motives beforehand, and provide them with incentives.

Reproductive tract infection and health seeking behaviour: a cross sectional community based study

Background: Women in India have multitude of health problem, which ultimately affect the economic output. The health of Indian women is intrinsically linked to their status in society. There is significant gap in understanding the reproductive tract infections as well as consequence for women lives. The objective of the study was to study the prevalence of reproductive tract infections and sociodemographic factors responsible among ever married women.Methods: Community based cross sectional study was carried out in the rural area near Mumbai city. List of villages in the study area was obtained from primary health centre (PHC). The prevalence of reproductive tract infections among ever married women was 20.7%. At 95% confidence level and 5% allowable error sample size is 262 (n=4*p*q/l2). So the sample size required to document RTI was 265 ever married women.Results: Prevalence of reproductive tract infections was 143(53.96%). Most common morbidity found was vaginal discharge 59 (22.26%). There was a significant difference between the proportions of study subjects with reproductive tract infection with respect to their educational status & occupation.Conclusions: There was high prevalence of reproductive tract infection among study subjects with only 13.74% visited a qualified medical practitioner for their complaints.

Catastrophic Health Expenditure and Impoverishment Effects of Out-of-pocket Expenses: A Comparative Study of Tannery and Non-tannery Workers of Kanpur, India.

Purpose:Treatment-seeking behaviors and economic burden because of health expenditure are widely discussed issues in India, and more so in recent times. The aim of this study is to identify health problems of tannery workers and their treatment-seeking behavior and their health expenditure.Data and Methods:The primary data used in this article were collected through a cross-sectional household survey of 284 male tannery workers in the Jajmau area of Kanpur city in the state of Uttar Pradesh, during January–June 2015.Results:Findings of the study revealed that around 36% of the tannery workers and 42% of non-tannery workers received treatment as outpatients in government/municipal hospital in the first spell of treatment. The secondary source of treatment was pharmacy/drug stores for 30% of the tannery workers and 24% of the non-tannery workers, an indication that a substantial proportion takes treatment without consulting a qualified medical practitioner; it also highlights that almost one-third of the tannery and non-tannery workers visited private health facility despite poor economic condition. It is evident that a substantial proportion of tannery and non-tannery workers are visiting private/non-governmental organization/trust hospital despite their poor financial situation.Conclusion:There is an urgent need to reinstate people's faith in public health facilities by developing professionalism, integrity, and accountability among different levels of health functionaries and frontline workers with the support of credible, transparent, and responsible regulatory environment.

Misuse of topical corticosteroids and attitude towards self-medication: a rising alarm

<p class="abstract" style="margin-bottom: .0001pt;"><strong><span lang="EN-US">Background:</span></strong>Topical corticosteroids (TC) are among the most commonly used medications for treatment of skin disorders. They give immediate relief from symptoms in many inflammatory dermatoses. Even inappropriate use in infectious dermatoses relieves the symptoms. This study was done to analyze the misuse of topical corticosteroids in Indian population and to analyze the attitude of patients towards self-medication.</p><p class="abstract" style="margin-bottom: .0001pt;"><strong><span lang="EN-US">Methods:</span></strong>All patients presenting with various dermatoses to the investigator were asked about history of usage of any topical medication on the lesion. In case of a positive answer, the investigator ascertained whether the topical medication in question contained a corticosteroid. The total number of patients seen during the recruitment period (January 2012 – December 2012) was noted on a separate list. Full questionnaires were only filled for patients with history of using topical corticosteroids<span lang="EN-US">.<strong></strong></span></p><p class="abstract" style="margin-bottom: .0001pt;"><strong><span lang="EN-US">Results:</span></strong>5256 patients were screened out of which 4100 (78%) were already using topical medications. 3154 (60%) patients were using topical steroid in various forms. About 80% of the patients using topical steroids confessed that they have not consulted qualified medical practitioner. They were advised these medications by chemists, friends or quacks, neighbours, barbers, beauticians etc.</p><p class="abstract" style="margin-bottom: .0001pt;"><strong><span lang="EN-US">Conclusions:</span></strong>Misuse of topical corticosteroids is common in Indian population and results in various complications. Educating public, chemists, general practitioners along with strict vigil by law enforcing agencies is needed for optimal and safe use of corticosteroids.</p>

Cerebral migrational defects and periventricular calcifications in a case of congenital CMV infection

A 10-day-old full-term male newborn, product of a non-consanguineous marriage, presented with history of intractable seizures since birth, which did not respond to conventional anticonvulsants. The baby was delivered normally at home and cried immediately after birth. The mother was a 25-year-old primigravida. The antenatal period was uneventful except for an episode of fever and nonspecific rash during first trimester of pregnancy. The mother did not have any antenatal check-up by a qualified medical practitioner. On examination, the baby had intrauterine growth retardation (weight 1850 g, length 44.3 cm) microcephaly (head circumference 32.2 cm) with wide-open anterior fontanel, purpuric spots, hepatosplenomegaly and generalized hypertonia. Ophthalmological examination showed bilateral chorioretinitis. Metabolic and sepsis screening re-

Chronic myeloid leukemia presented with priapism: Effective management with prompt leukapheresis

Priapism is a painful medical condition in which the erect penis does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within 4 h. Priapism is considered a medical emergency, which should receive proper treatment by a qualified medical practitioner. Treatment initially involves conservative measures, such as corporeal aspiration and irrigation with saline or dilute phenylephrine. If this fails, embolization or surgical shunting may be required. Priapism is more commonly associated with sickle cell hemoglobinopathy. However, hyperviscosity resulting from leukemia is a rare cause of priapism. We report a case of a 19-year-old man with an 18-h history of priapism secondary to undiagnosed chronic myeloid leukemia. We discuss the method of leukapheresis (mechanical white cell depletion) to reduce viscosity.

Clinical Profile of Mid Day Meal Beneficiaries of Primary Schools in Kurukshetra District

The various aspects of clinical profile in mid day meal beneficiaries, between the age group of 6-11 years from Kurukshetra district have been studied. One time observational study of five hundred government primary school children was conducted. A qualified medical practitioner was associated for clinical examination of children having mid-day-meal. Clinical symptoms observed were noted in the structured schedule. Observation of clinical signs reveal the anatomical changes due to malnutrition like deficiency disorders for iron, Vitamin A, B-complex, C and D. Symptoms of anemia were observed at a higher rate in girls than boys. Spongy (9.2%) and bleeding (5.3%) gums indicating Vitamin C deficiency was recorded in few subjects. Bones were found normal except few children who were diagnosed with distal wrist/ bowed legs/ pigeon chest. However, the prevalence of these nutritional deficiency disorders may be attributed to their poor nutritional status. Nutrition intervention in the form of supplementation and education in primary schools along with families, teachers and communities has to be strengthened to effectively address malnutrition.

Overt hypothyroidism in pregnancy: Can we consider medical termination of pregnancy?

Overt hypothyroidism in pregnancy: Can we consider medical termination of pregnancy?

When only a doctor will do

When only a doctor will do

Harmful Traditional Practices Adversely Affecting Child Health in Aligarh

This study is based on the practical field experiences and observations related to infant health in the community. Harmful traditional practices prove to be bottlenecks and create numerous hurdles in achieving the goal of reduction in infant mortality rate. These practices need to be eradicated from the community to improve the health standard of the state and in turn the country. Lives of children may be saved by counselling their parents and other family members. Some of the prevalent practices among the community are discrimination between male and female child; first bath immediately after birth; keeping babies for few days without any clothing; cutting the umbilical cord with khurpa, hasiya, piece of pot or glass; keeping sharp objects close to the newborn like knife, blade, etc.; burning smoke near the newborn; confinement of mother and child for a few days; applying kajal in the eyes of the infant; keeping shoes with the newborn; avoiding vaccination; throwing away of colostrum – the first milk; reluctance in adopting exclusive breastfeeding; and feeding with pre-lacteals, e.g., ghutti, pehuwa and honey These practices adversely affect the health of infants. Often it was observed that in case of illness, some Ojha was being consulted rather than a qualified medical practitioner. The images provided in this study present the suffering of the children due to these malpractices.

Internet pharmacies

Shopping on the internet has become routine for many people and covers a wide range of products and services. It is therefore unsurprising that, in some countries, medical and pharmaceutical services can also be bought. This has clear advantages in countries such as Australia, where some communities are isolated by huge distances (or other geographical circumstances) but are able to access the internet. However, shopping for psychotropic substances is not quite the same as shopping for toothpaste or televisions. These drugs are subject to strict controls, including the requirement for prescription by a qualified medical practitioner. It is possible to implement systems so that internet shopping for and mail delivery of psychotropic substances conform to regulatory requirements; if this is done, internet pharmacies can be valuable in ensuring an adequate supply of medical provisions to all citizens, wherever they live (US General Accounting Office, 2000). However, these same sales opportunities can easily be exploited by unlicensed internet pharmacies and it is the problems caused by these illicit ‘cyber-pharmacies’ that are now the cause of grave concern.

Drug advertising in vehicles on Nigerian highways: Commuters' reasons for patronage—A pilot study

People who are unwell and wish to recover as quickly as possible normally visit a qualified medical practitioner first, however in many parts of Nigeria self-medication seems to be on the increase. The reasons for this may simply be the cost of orthodox medical treatment or the shortage of appropriately qualified medical personnel. Another possibility is that self-medication is being actively encouraged by large numbers of ‘drug hawkers’ who target vulnerable people. These ‘hawkers’ are frequently found travelling on commuter buses, offering cheap medicines for many common ailments. The aim of this study was to determine what justification these commuters could have for patronising the drug hawkers, and to see what measures could be taken to halt the practice. A total of 120 male and 120 female commuters took part in the study, which was carried out in the Booking and Departure premises of five transport companies in Onitsha, Anambra State, Nigeria. Questionnaires were used to collect data by means of a two-point Likert format containing ten possible reasons why consumers patronised drug hawkers. The results of the study determined the reasons why consumers patronised the drug advertisers: 1. Affordability 2. Belief in the ‘hawkers’ 3. Faith in the hospital service. Recommendations made include public education campaigns on self-medicating and resistance issues, and public education and media announcements to dismantle open drug markets.

Are doctors responsible for delay in cancer management?

6101 Background: Cancer patients in developing countries are still in advanced stage of their disease by the time they receive anticancer therapy despite rapid advances in medical sciences. It is commonly believed that this occurs due to late presentation of cancer patients to their physicians because of illiteracy, poverty and ignorance but is it true? Material and Methods: Cancer patients attending Surgical Oncology clinics between 2000 -2003 at Regional Cancer Centre, PGIMS, Rohtak in India were studied by detailed questionnaire in two phases to know the time of onset of symptoms, time of presentation of the patients to the physicians, details of the consultation and action taken thereafter by the physicians. Presentation interval (period from onset of symptoms to presentation of the patients), diagnostic interval (period from time of presentation to establishment of diagnosis of cancer) and treatment interval (period from establishment of diagnosis to initiation of anticancer therapy) were calculated. Delay was said to have occurred if presentation & diagnostic intervals exceeded one month each and treatment interval exceeded two weeks. The physicians to whom cancer patients presented first were called as primary care physicians (PCP) and were divided into 3 categories of qualified medical practitioner, qualified non-medical practitioner and unqualified medical practitioner.At the end a total of 1006 patients were available for analysis. Results: Majority of the patients has poor socioeconomic status with very low literacy level and three forth of them were not aware about cancer still 67.3% patients presented to primary care physicians without delay. 75.9% of the patients had delay at diagnosis level and physician was responsible for this delay in 60.4% of the patients. The unqualified physicians and qualified non medical practitioners almost never diagnosed cancer while 2/3rd of the qualified physicians also did not diagnose cancer but gave only symptomatic treatment. Conclusions: Despite poverty, illiteracy and poor cancer awareness majority of the patients presented without delay to their physicians but significant delay occurred in most of the patients at diagnosis level and physician was mainly responsible for this delay. No significant financial relationships to disclose.