Objective. The aim of study was to examine the factors associated with the use of herbal drugs among patients in Serbia, as well as to assess the attitudes and habits of patients toward the use of herbal drugs. Methods. The study was designed as an observational, cross-sectional study. The research was conducted during February 2018 in six community pharmacies across the municipalities of Despotovac and Ćuprija. Study population consisted of adult volunteers of both genders and over 18 years of age who had purchased drugs in one of the six pharmacies involved in the study. Participants filled out the semi-structured questionnaires which had been specifically designed for purposes of this research. The questionnaire consisted of two parts. The first part comprised five questions relating to socio-demographic characteristics of participants, while the second part of the questionnaire was composed of eight questions concerning the use of herbal products. The study data were analyzed by descriptive and analytical statistics by SPSS statistical program. Results. There were 190 participants in total. The average age of the study subjects was 47.83 ± 15.9 years (the youngest was 18, while the oldest was 87 years old). Some form of herbal product was used by 145 (76.3%) participants. The most common reasons for the use of herbal drugs were common cold (22.6%), improving the digestion (8.9%), stimulation of immune system (7.5%), dermatological problems (7.5%), cough (4.8 %) and rheumatic complaints (4.8%). The most frequently participants gained information on use of herbal drugs from pharmacists (26.9%), from sources provided by Internet (21.0%), from their physicians (11.8%) and from family members and friends (10.8%). Of the total number 67.7% of participants considered herbal drugs to be completely safe for use. Slightly more than half of the study subjects (52.7%) gave information on using the herbal drug to their physicians. The binary logistic regression analyses showed that herbal drugs were more commonly used by younger women, with a higher school or university degree who prefer to use herbal medicines compared to other drugs. Conclusion. The results of our study have shown that herbal drugs had been more commonly used by younger women, with a higher school degree or university degree, and who declared that they preferred to use herbal drugs in relation to other drugs.
Postmenopause and smoking impair lipid profile, induce hypercoagulability and reduce fibrinolytic capacity [1, 2]. Postmenopause induced lipid changes can be reversed by oestrogen replacement [3]. Oestrogens also reduce fibrinogen level [4] and have beneficial effects on endothelium [5]. Although several studies showed that hormone replacement therapy may increase the risk of thromboembolic diseases, procoagulant oestrogen activity has not clearly been demonstrated. It is well known that smoking accelerates oestrogen metabolism [6, 7], which may attenuate its beneficial effects. The present study was undertaken to determine if there is difference in beneficial effects of oestrogens between smokers and non-smokers in terms of coagulation process and lipids. The examination was a longitudinal, one-year, before/after therapeutic study, which included healthy postmenopausal women (FSH levels at least 40 U/l), 30 smokers and 32 non-smokers who were under 55 years of age and postmenopausal period shorter than 5 years. Women with surgically induced menopause received unopposed oral oestrogens, while those with spontaneous menopause were treated with combined oral oestrogen/progestogen therapy. Before entering the study and in three-months intervals total LDL, HDL cholesterol, triglycerides and VLDL were determined, as well as plasma fibrinogen, prothrombin time, and activated partial thromboplastin time. Neither beneficial nor adverse effects of oestrogens on lipids and coagulation were observed during one-year follow-up in smokers, although subjects with longer smoking history had higher triglycerides levels after 12 months of therapy. On the contrary, oestrogen replacement reduced total and LDL cholesterol, and increased HDL cholesterol in non-smokers, with no change in triglycerides and VLDL level. A decrease in fibrinogen levels and coagulation activity, expressed by prothrombin time and partial thromboplastin time, were also observed in hormone replacement therapy in postmenopausal women who did not smoke. Peroral hormone replacement therapy does not induce favorable lipid changes in smokers. Higher triglycerides levels observed after one-year therapy in women with a longer smoking history indicate that transdermal replacement maybe more suitable in this group. Peroral oestrogen replacement has no anticoagulant or procoagulant activity in smokers during the early postmenopausal period.
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