Background: Self-medication is a common practice in Bangladesh as it provides a low-cost alternative for people, which involves inappropriate and injudicious use of medicines treat self-recognized symptoms by the people.Methods: A cross sectional online survey was conducted on 626 citizens by structured questionnaires during COVID-19 outbreak from April to May 2020 in Dhaka city, to observe the prevalence, pattern and sources of self-medication among the respondents with high socio-economic standings and education.Results: The prevalence of self-medication amid the outbreak of COVID-19 was 88.33% and only 179 (28.59%) took medication with doctors’ advice and remaining 447 (71.40%) respondents took the drugs as “self-medication” by other sources. The most frequently used prescription-only drug during the outbreak were ivermectin (77.15%), azithromycin (54.15%), doxycycline (40.25%). The common symptoms for which the respondent took self-medications were fever, throat pain, dry-cough and total 105 (16.77%) respondents took medications without having any symptoms. Almost 355 (85.33%) had taken medication without doing any test for COVID-19. This could be due to unusual distress, caused by high self-awareness of their health and buying capacity of medication.Conclusions: The study revealed the causes of self-medication as news of spread, effects and remedies in media channels, internet; mental stress of lockdown and isolation, insecurity and panic about scarcity of drug and healthcare support. High risks of developing antibiotic resistance, adverse drug reactions and financial loss was predictable with absence of strict regulatory enforcement to protect people and proper utilization resources during COVID-19 outbreak in Dhaka city.
Background: The outbreak of coronavirus disease-2019 is putting a massive strain on vulnerable healthcare system in low and middle-income countries like Bangladesh. Inequitable access to healthcare is further widened by the socio-economic gap and sense of insecurity during this pandemic. Self-medication is a common practice in Bangladesh as it provides a low-cost alternative for people, which involves inappropriate and injudicious use of medicines to treat self-recognized symptoms by the people. During the outbreak of COVID-19 in Dhaka city, the tendency of taking medicines by own decision was thought to be increased alarmingly due to unusual distress, caused by high self-awareness of their health and buying capacity of medication. Objectives: To observe the prevalence, pattern, sources and impact of self-medication practice among the respondents with high socio-economic standings and education. Setting: Citizens living in Dhaka city, Bangladesh during COVID-19 outbreak from April 2020 to May 2020. Method: Cross sectional online survey conducted on 626 citizens without having background of medical knowledge or related to any healthcare services (doctors, nurses, pharmacist, medical students) by structured questionnaires during COVID-19 outbreak. Outcome measures: Frequency of self-medication, commonly used antimicrobial agents, symptoms causing self-medication, sources of inspiration, relation with COVID-19 test results, economic burden involved in self-medication during outbreak. Results: The prevalence of self-medication amid the outbreak of COVID-19 was 88.33% and only 179 (28.59%) took medication with doctors’ advice and remaining 447 (71.40%) respondents took the drugs as “self-medication” by other sources. The most frequently used anti-infective drugs during the outbreak were ivermectine (77.15%), azithromycin (54.15%), doxycycline (40.25%). The common symptoms were fever, throat pain, dry-cough and total 105 (16.77%) respondents took medications without having any symptoms. Almost 355 (85.33%) had taken medication without doing any test for COVID-19. The causes of self-medication as news of spread, effects and remedies in media channels, internet; mental stress of lockdown and isolation, insecurity and panic about scarcity of drug and healthcare support. Conclusion: High risks of developing antibiotic resistance, adverse drug reactions and financial loss was predictable with absence of strict regulatory enforcement to protect people and proper utilization resources during COVID-19 outbreak in Dhaka city.
Background: The study aimed to analyze the demographic, comorbidities, biomarkers, pharmacotherapy, and ICU-stay with the mortality outcome of COVID-19 patients admitted in the intensive care unit of a tertiary care hospital in a low-middle income country, Bangladesh. Methods: The retrospective cohort study was done in Holy Family Red Crescent Medical College Hospital from May to September 2020. All 112 patients who were admitted to ICU as COVID-19 cases (confirmed by RT-PCR of the nasopharyngeal swab) were included in the study. Demographic data, laboratory reports of predictive biomarkers, treatment schedule, and duration of ICU-stay of 99 patients were available and obtained from hospital records (non-electronic) and treatment sheets, and compared between the survived and deceased patients. Results: Out of 99 patients admitted in ICU with COVID-19, 72 were male and 27 were female. The mean age was 61.08 years. Most of the ICU patients were in the 60 - 69 years of age group and the highest mortality rates (35.89%) were observed in this age range. Diabetes mellitus and hypertension were the predominant comorbidities in the deceased group of patients. A significant difference was observed in neutrophil count, creatinine and, NLR, d-NLR levels that raised in deceased patients. There was no significant difference as a survival outcome of antiviral drugs remdesivir or favipiravir, while the use of cephalosporin was found much higher in the survived group than the deceased group (46.66% vs 20.51%) in ICU. Conclusions: Susceptibility to developing critical illness due to COVID-19 was found more in comorbid males aged more than 60 years. There were wide variations of the biomarkers in critical COVID-19 patients in a different population, which put the healthcare workers into far more challenge to minimize the mortality in ICU in Bangladesh and around the globe during the peak of the pandemic.
Background: Pharmacovigilance is proven as an effective monitoring mechanism for safety and efficacy of pharmaceutical products with the assistance of physicians, pharmacists, nurses, and other healthcare professionals to avoid undue physical, mental and financial suffering of patients. Thus, this study was conducted to assess awareness of pharmacovigilance among the healthcare service providers to evaluate the acquaintance, approach application (3A) of judicial reporting of ADRs and pharmacovigilance in a tertiary care teaching hospital in Dhaka.Methods: A pre-tested questionnaire-based study was done among the 5th year medical students, interns, doctors and nurses of Holy Family Red Crescent Medical College, Dhaka, Bangladesh to assess the overall status of acquaintance (knowledge), approach (attitude) and application (practice) pharmacovigilance. Total 417 questionnaires were distributed and 389 were included as valid, compiled and analysed using SPSS version 25.0.Results: Among the respondents, almost 78% of the nurses responded the right answers and doctors responded the lowest 29% on average. The average percentage of approach and application of pharmacovigilance was low in all the respondent groups. The poorest outcome was observed about reporting an adverse drug reactions (ADR) form by all respondents as 01% to 08%.Conclusions: The overall status of pharmacovigilance in a tertiary teaching hospital was found paradoxically low, that revealed the necessity of much more initiatives at the undergraduate and postgraduate academic curriculum and intensive motivation, training, monitoring should be addressed to ensure the safety of medication, rationality of drug use and accomplish the national pharmacovigilance programs.
Background: The outbreak of coronavirus disease-2019 is putting a massive strain on the vulnerable healthcare systems in low and middle-income countries like Bangladesh. Inequitable access to healthcare is further widened by the socio-economic gap and sense of insecurity during this pandemic. Self-medication is a common practice in Bangladesh as it provides a low-cost alternative for people, which involves inappropriate and injudicious use of medicines to treat self-recognized symptoms by the people. During the outbreak of COVID-19 in Dhaka city, the tendency of taking medicines by own decision was increased alarmingly due to unusual distress, caused by high self-awareness of their health and buying capacity of medication. Objectives: To observe the prevalence, pattern, sources, and impact of self-medication practice among the respondents with high socio-economic standings and education. Setting: Citizens living in Dhaka city, Bangladesh, during the COVID-19 outbreak from April 2020 to May 2020. Method: Cross-sectional online survey conducted on 626 citizens without having a background of medical knowledge or related to any healthcare services (doctors, nurses, pharmacists, medical students) by structured questionnaires during the COVID-19 outbreak. Outcome measures: Frequency of self-medication, commonly used antimicrobial agents, symptoms causing self-medication, sources of inspiration, relation with COVID-19 test results, economic burden involved in self-medication during the outbreak.
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