Buying Ecstasy online in Mymensingh

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Buying Ecstasy online in Mymensingh

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Doctor Consultation : MedEasy provides access to various qualified and experienced medical professionals across Bangladesh. Lab Tests : MedEasy also offers affordable access to a wide range of lab tests. Health Records MedEasy also provides access to health records. Medical Advice and Support : MedEasy also provides access to medical advice and support from qualified medical professionals. Comprehensive Database of Healthcare Providers : MedEasy also provides access to a comprehensive database of health care providers in Bangladesh. Discounts and Deals : MedEasy also offers discounts and deals to help make health care services more affordable. Home 0.

Best Online Pharmacy And Health Care Platform in Bangladesh

Buying Ecstasy online in Mymensingh

Official websites use. Share sensitive information only on official, secure websites. Email: donna. From January to April , patients entering two hospitals in Phnom Penh, Cambodia, were surveyed. Information, including symptoms when the medication was purchased, possible side effects, hospital presenting symptoms, etc, was recorded. Efforts to educate the public about their medications and the potential risks of medications are needed. Cambodia is a rapidly developing country in Southeast Asia that suffered a decimation of its doctors and medical staff during the Pol Pot regime in the —90s. Non-physician prescribers NPP frequently fill the void in those regions, though many may have no formal medical training. Some NPPs focus primarily on selling medication, providing guidance to patients as to which medication to buy based on their symptoms. Other NPPs may open private practices and, in addition to providing advice after clinical evaluation, may sell medication. Some of these NPPs may be trained nurses, though unlikely trained as nurse practitioners. Small villages may have governmental health centers, some staffed with trained mid-level healthcare personnel, others with staff who have uncertain training. Licensed pharmacists may also be limited in these regions. Retail shops can also sell prescription medications, with the store clerk providing medication guidance. Finally, medications and medical advice may come from village healers providing traditional Khmer medication. Literature describing this practice is difficult to find. Acetaminophen caplet for size comparison. In the United States, where prescription medication is only provided by licensed healthcare workers, medication errors account for a significant proportion of overall medical errors. While information regarding the dispensing of antibiotics without prescriptions by pharmacists can be found in the literature, limited information is available concerning the scope and details of all types of non-physician prescribing. What is the scope of all types of prescription medication usage without consultation? Do patients understand medication risks? Three-quarters required prescriptions in the US. This study has two goals. Both sites are staffed by the same group of physicians. The two hospitals primarily see adult patients with various medical problems. Known human immunodeficiency virus HIV patients were seen by infectious disease physicians separately. A convenience sample of stable, consenting patients visiting one of the two study sites was eligible for enrollment after triage by a nurse Figure 2. Two trained, bilingual Cambodian nurse research assistants RA assessed whether patients met inclusion criteria and then verbally administered the survey to all patients. All patients were eligible except those requiring immediate medical care. However, those not initially eligible could become eligible for enrollment after their condition had stabilized. All patients gave written or thumbprint informed consent. Enrollment criteria for stable patients in Cambodia studied for identification and knowledge of their current medications. ED , emergency department; NPP , non-physician prescriber. A item questionnaire Appendix A was verbally administered by a trained RA to those using medication provided by NPPs within two weeks before presentation. Patients were asked whether they requested medical advice from the prescriber and if the prescriber asked questions, such as other symptoms, past medical history, other medications, allergies, or pregnancy. After physician evaluation, information was obtained from the medical chart including discharge diagnosis, past history, and ancillary tests. Specific medication side effects were not asked by the RAs, but once a patient reported new symptoms, the RAs and the authors some of whom were present during the first month of data collection were encouraged to ask further details to help clarify the likelihood the symptom was related to the medication. For instance, one patient who self-prescribed chronic steroids for no known reason, brought in recent radiographs demonstrating progressive bilateral femoral head necrosis. Patients using both non-steroidal anti-inflammatory drugs NSAID and steroids for chronic pain frequently complained of post-use gastric irritation, and some were noted to have iron deficiency anemia. First, the study documents various aspects of NPP prescribing practice. Descriptive statistics were used to summarize the data. Categorical data were summarized as counts and percentages frequency of occurrence. Continuous data were summarized as means and standard deviations. Because this was not a hypothesis-testing study, no formal sample size calculation was performed. The study was conducted over a four-month period during which funding and research personnel were available. During the study period, patients were enrolled. Twelve were excluded, either because their recorded medications were used before the two-week study cutoff or a physician potentially prescribed their medications. Patients travelled an average of 2—2. Patients who described taking purely herbal Khmer traditional medications were not included. The table lists other prescribing sources. A small number of patients were unable to distinguish whether their prescriber was a doctor or another type of practitioner. Others could not distinguish a store clerk from a pharmacist. Pharmacies may hire sellers who advise patients but may not be pharmacists. Few NPPs asked patients for additional medical information before prescribing. Many patients received medication in a plastic bag with simple dosing directions written with a marker on a plastic bag, but usually without the drug name. Occasionally, blister packs were given name typically in English , with dosing instructions written on the blister pack. While the inclusion criteria required patients to have purchased NPP medication within the prior two weeks before presentation, many medication treatments had actually begun months or years prior, particularly anti-diabetic medication, anti-hypertensives, and steroids. Corticosteroids were a common class of medication for which patients reported new symptoms after starting the medication. Additionally, a few patients demonstrated possible, but unconfirmed, signs of adrenal insufficiency after they recently stopped using chronic steroids. It was also the most common reason steroids were prescribed desired weight gain, respiratory issues, toothache, and rashes were less common reasons. Only one patient received a subcutaneous injection, possibly insulin, which may not have necessarily required a prescription in the US. Only three patients knew the names of their injectable medications two steroids, vitamin C, and meloxicam. Occasionally, a retail seller performed the injection, and a few injections were intra-articular. However, many patients reported not receiving any information concerning diabetic medication side effects. Of the two diabetic patients who suffered hypoglycemic reactions, neither was aware that eating less might result in hypoglycemia. Of the 30 patients who knew they were diabetic, 26 were taking an anti-diabetic medication, although seven did not know the exact name. Antibiotics were frequently prescribed for non-infectious conditions. Additionally, many of those prescribed an antibiotic for an infectious etiology would not have benefited because the disease ultimately diagnosed at the hospital required a different or more complex form of treatment, ie, septic arthritis, tuberculosis, melioidosis, etc. Examples of specific medication issues in selected patients can be found in Appendix B. Though this study has inherent limitations, it does shed light on several issues concerning non-physician prescribed treatment. Many Cambodians lack easy access to physicians, but more than half were able to obtain NPP-prescription medication before presentation to the hospitals. We did not specifically count the number of patients given medications without written names; however, many medications were dispensed in this manner ie, placed in a plastic bag without a name. It is difficult to identify adverse drug events and even more difficult to prevent future episodes when names are unknown. Failed therapies from the past cannot easily be identified, since once a drug is finished, there is rarely any documentation of the medication prescribed. Verbal information alone may have sufficed in the past when many could not read, but, in our population, more than two thirds of patients were able to read at a basic elementary level and many non-readers have younger family members who could read for them. Written medication information should be provided to all, in their own language, and it is important to emphasize that such information must be saved and brought to subsequent healthcare staff. Our survey questioned patients about potential medication side effects; however, it would be difficult, considering the study design, to confirm with absolute certainty that the symptoms patients experienced after usage were necessarily caused by the medication. However, a number of patients did report a variety of new symptoms particularly related to chronic steroid usage. One patient bought an herbal medication from Malaysia that has been banned in the US after a Food and Drug Administration analysis revealed the medication was not purely herbal, but contained steroids and cyproheptadine. Chinese herbal medications, also used by Cambodians, may also be mixed with steroids, but our study did not independently confirm this. Knowledge or lack of knowledge of chronic steroid use affected the differential diagnosis and management of certain patients with infections. One patient with a long history of steroid use presented with clinical signs of sepsis, progressive fever, shortness of breath, and weakness, and died soon after admission. Although a specific infectious diagnosis was not made, her management and differential were influenced by the knowledge of her chronic steroid usage. Her treatment included stress dose steroids and treatment for possible strongyloidiasis, a common asymptomatic local parasitic infection caused by Strongyloides that is known to disseminate when using steroids. Our present study was also not designed to pick up risks from the common practice of injecting medications; however, there has been past evidence of risk. A few years ago, the Ministry of Health actively discouraged this practice after a NPP was discovered to have infected multiple patients with HIV by reusing the same non-sterile needle to inject his patients. Injections were found to be the most common type of prescribed medication in this study, yet virtually no one knew the medication that was administered. This is an area that would likely benefit from further studies. While this study may not be able to generalize the specific findings to other regions of the world, it is likely that many of these same issues can be found in other locales. Non-physicican providers may provide a great benefit to patients, particularly those with chronic diseases, such as hypertension and diabetes, who do not have easy access to a doctor. Though two thirds of our NPP-treated diabetic patients presented with subsequent evidence of poor glucose control, one third demonstrated good control and this may not have been possible without local NPPs. However, one patient, diagnosed with diabetes by a physician, informed the RA that her doctor was insistent she take her medications daily, so she did. The NPPs should have an understanding of the disease for which they are providing medications in order to correctly advise the patient. Providing more trained medical workers, such as physicians and pharmacists, to help patients gain a greater insight into the medications they have purchased may take years. Stronger governmental oversight or intervention of medication prescribing may take time, too. However, patient education can begin now. Nurse educators could offer general medication sessions including information about medication allergies, common adverse reactions, and information about long-term disease management while patients and families wait at local clinics and hospitals. Basic pre-printed medication information may be useful for both NPPs and patients. The majority of the data in this convenience sampling of patients was based on patient self-report and may suffer from recall bias. Other study limitations include misinterpretations due to language and cultural differences, small sample sizes, accuracy of medical chart data, and the subjective nature of data analysis. Moreover, selection bias likely occurred as many of the sickest patients were not included in the study. Conversely, many patients prescribed medications by NPPs may never present to a healthcare facility because they improved. This study also lacks a physician comparison group; so the findings may not be representative of NPPs alone. Finally, the study may not be representative of other countries or regions in Cambodia as it was conducted at only two emergency departments in the capitol of Cambodia. Education is not only essential, but key to decreasing the risk of iatrogenic disease and helping patients become active participants in their own healthcare. Conflicts of Interest : By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. This research was funded by the Emergency Medicine Foundation. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. West J Emerg Med. Find articles by Donna Venezia. Find articles by Alexandra Cabble. Find articles by Diane Lum. Find articles by Kruy Lim. Find articles by Adam J Singer. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Retail store clerk or individual medication seller. Non-physician healthcare worker at village governmental clinic. Non-physician healthcare practitioner may or may not have medical training.

Buying Ecstasy online in Mymensingh