Many countries worldwide are currently struggling with medical workforce shortages and unequal distribution of healthcare workers between urban and rural areas. Medical deserts are defined as areas with insufficient access to healthcare services due to a shortage of qualified professionals. The emergence of medical deserts is attributed to physicians’ lower willingness to work in rural areas due to factors such as overburdened work conditions, lack of recognition, insufficient financial aspects, professional isolation, and socio-demographic factors like finding jobs for spouses or ensuring quality education for children. To address this issue effectively, understanding the motivations and decisions of future doctors is crucial. The choice of physicians’ specialization is complex and influenced by factors such as work conditions, prestige, economic conditions, personal interests, and psychological aspects. Altruism, curiosity, and a desire for prestige often drive a career in medicine, but these motivations are tempered by financial considerations, job market competition, and the availability of specialized training opportunities. The choice of medical specialization is further shaped by personality traits, research interests, and the demand for specific expertise in the healthcare system. Additionally, family influence, mentorship, and socialization play critical roles in shaping career trajectories, with parents’ professions and teachers’ attitudes often steering students toward particular fields. Addressing medical deserts requires a multi-faceted approach that understands these factors and develops policies and strategies encouraging future doctors to work in underserved regions.
Drug-induced liver injury (DILI) must be taken into consideration when a pregnant woman takes medications and presents symptoms of acute or chronic hepatitis, hepatocellular, cholestatic or mixed, as it poses a danger to both mother and fetus. Among causative medications, paracetamol is the most common, followed by antibiotics. There is a case report of a 24-year-old pregnant woman admitted to the Obstetrics and Gynecology Clinic with presentation of yellow discoloration of the skin and whites of the eyes, pruritus of the skin and clinical suspicion of gestational cholestasis. Due to skin lesions, stiff neck, cold sores, fever, and the presence of ANA and anti-Ro antibodies since the 21st week of gestation, the patient was treated with prednisone and hydroxychloroquine and was symptomatically treated with paracetamol. At the time of admission to the Clinic, laboratory tests showed elevated values of liver parameters and CRP. During hospitalization, an enlarged liver with dilatation of the hepatic ducts was revealed. The patient was consulted dermatologically and hepatologically, and tests for viral liver diseases were negative. Based on overall case analysis and the atypical clinical course, a drug-induced liver injury was suspected. After paracetamol and hydroxychloroquine were discontinued, the complete normalization of liver parameters was achieved. It must be underlined that DILI remains a diagnosis of exclusion, and thus testing for other causes of hepatic injury such as autoimmune hepatitis, acute viral hepatitis, ischemic liver injury, and Budd-Chiari syndrome is crucial. In case of a confirmed medical history of treatment with potentially hepatotoxic drugs, there is no need to perform a liver biopsy.
Hepatitis A is an acute viral liver infection caused by the hepatitis A virus (HAV), transmitted primarily via the fecal-oral route, with occasional sexual or parenteral transmission. While incidence in Poland and Europe remains low, sporadic outbreaks continue to occur, reinforcing the need for vigilance in primary care. Clinical presentation ranges from asymptomatic to symptomatic infection, with children more often experiencing asymptomatic or mild disease, while adults more commonly develop symptomatic illness, including fatigue, anorexia, nausea, vomiting, abdominal discomfort, and cholestatic features such as jaundice and pruritus. Laboratory evaluation typically reveals elevated aminotransferases, bilirubin, and, in some cases, alkaline phosphatase. Diagnosis relies on serological confirmation, with anti-HAV IgM indicating acute infection and IgG reflecting past infection or vaccination. Management is largely supportive, focusing on hydration, nutritional maintenance, and monitoring for complications. Symptomatic therapies include antiemetics (ondansetron or metoclopramide) against vomiting, acetaminophen against fever and malaise, and cholestyramine or rifampicin against cholestatic pruritus. Refractory cases may benefit from opioid antagonists or selective serotonin reuptake inhibitors. Family physicians play a critical role in patient education, emphasizing hand hygiene, food safety, and sexual hygiene, as well as in postexposure prophylaxis using hepatitis A vaccine or immune globulin. Vaccination remains the most effective preventive measure, with high immunogenicity and long-term protection, significantly reducing disease incidence and complications. Special attention is warranted for high-risk populations, including young children, travelers, immunocompromised individuals, and those with chronic liver disease. Early recognition, monitoring, and preventive strategies in primary care are essential to mitigate transmission, prevent severe disease, and reduce impact on public health.
Background. Long-distance truck drivers are considered a high-risk population in the transmission of HIV due to their occupational mobility, prolonged time away from home, and frequent encounters with commercial sex workers. In Indonesia, particularly on the island of Sulawesi, roadside eateries and coffee stalls often serve as informal meeting points where transactional sex occurs between truck drivers and female vendors. Despite the growing concern over sexually transmitted infections (STIs) among mobile workers, limited data exist on the sexual behavior patterns of this occupational group in the region. Objectives. The aim of this study was to explore the prevalence of transactional sexual behavior and its potential linkage with HIV risk among truck drivers who travel across the Sulawesi island. The study also aimed to identify age-based patterns in sexual behavior and frequency of engagement in paid sex during transit stops. Material and methods. This cross-sectional survey was conducted over a 14-month period, from January 2024 to February 2025. A total of 600 male truck drivers aged 17-52 years were recruited using accidental sampling techniques at provincial roadside stops throughout Sulawesi. All participants completed a structured and anonymous questionnaire that gathered data on sociodemographic characteristics, sexual practices while in transit, and history of interactions with female food or beverage vendors. Participants also reported the average payment made per sexual encounter and the consistency of condom use. Ethical approval was granted by the institutional ethics board, and informed consent was obtained from all respondents. Results. Out of the 600 truck drivers surveyed, 421 (70.2%) reported engaging in transactional sex during their journeys across Sulawesi. Most interactions occurred with female food or beverage vendors stationed along major trucking routes, where truck drivers paid approximately 100,000 Indonesian Rupiah (IDR) per sexual encounter. Age distribution among those engaging in transactional sex revealed the highest prevalence in the 20-35-year-old group (69%), followed by those aged 36-52 years (20%) and 17-19 years (11%). A significant proportion of drivers admitted to inconsistent condom use, and several acknowledged a lack of awareness regarding HIV prevention measures. These behaviors may contribute to increased vulnerability to HIV and other STIs within this mobile population. Conclusions. The findings of this study highlight a high frequency of risky sexual behavior among long-distance truck drivers operating across Sulawesi. The transactional nature of these interactions, often with limited protection and low awareness of disease transmission, underscores the urgent need for targeted public health interventions. Mobile health outreach, education programs focused on STI prevention, and increased access to condoms and HIV testing services are recommended to reduce the potential spread of HIV in this key population and the wider community.
Background. The global prevalence of parasitic diseases constitutes a significant public health concern. A substantial proportion of the human population is affected by intestinal parasitic infections caused by numerous protozoa and helminth species. Primary factors that prevent parasitic infections in the intestinal tract include proper hygiene practices, ensuring safe food handling and heat treatment, as well as consuming clean and safe water. Objectives. To analyze the knowledge and awareness of Polish adults regarding the health risks associated with intestinal parasitic infections. Material and methods. The study was conducted among 157 subjects (aged between 18 and 65) over three months. Participants were recruited through convenience sampling via online announcements. An original, anonymous questionnaire was used in order to assess their knowledge of and awareness regarding the study theme, along with socio-demographic characteristics. Spearman correlation coefficients were calculated as the primary measure of agreement between gender, age, socio-occupational status, and place of residence with the survey data. Results. While many respondents exhibited an awareness of the general terminology to describe parasites, certain knowledge gaps were identified, particularly about risk factors, treatment options, and the prevention of parasitic infections. A statistically significant association was identified between the variables of self-assessed knowledge on parasitic diseases and respondents' status and age, respondents' attitudes towards the asymptomatic course of intestinal parasitic infections and age, and respondents' attitudes towards the possibility of curability of gastrointestinal parasitic diseases according to their gender. Conclusions. It is essential to enhance public awareness of intestinal parasites within the Polish population. This would be a significant measure that would lead to a considerable reduction in the prevalence of parasitic infections and improve public health.
Background. Osteoarthritis of the knee is a common cause of knee pain and can be associated with significant disability. Topical treatment with etofenamate gel may be effective in relieving knee pain. Objectives. The objective of the study was to assess the efficacy of etofenamate gel used for knee pain from the perspectives of patients and pharmacists. Material and methods. The study was conducted by 10 pharmacists in 20 randomly selected community pharmacies in Poland between December 2023 and April 2024. Data were collected during three patient visits: Visit 1 (baseline), Visit 2 (after 7 days of treatment), and Visit 3 (14 days after the baseline visit). Etofenamate was applied topically to the painful knee 3-4 times daily for 14 days. The VAS scale, KOOS questionnaire, and General Pharmacist Assessment were used to evaluate the outcomes. A total of 158 patients with knee pain participated in the study. Results. Initially, patients most commonly rated their pain intensity at levels 6 and 7 in the last 24 hours (24.46% and 29.50%, respectively) and at levels 5 and 6 in the past week (23.02% and 25.18%). Ultimately, 84.89% of patients reported improvement or significant improvement, which was confirmed by objective assessments from the researchers (pharmacists). Etofenamate was highly rated for ease of application, absorption speed, feeling of freshness, odor, and non-greasy feel. Conclusions. Etofenamate gel proved to be an effective treatment for reducing knee pain in patients.
Background. The health of university students largely depends on their daily dietary choices, with their nutritional knowledge influencing diet quality and overall well-being. The study period often encourages irregular eating habits, which may lead to adverse health effects. This research fills a gap in comparative nutritional analyses of Polish students, providing valuable insights for Central and Eastern European medical communities and practical implications for health education. Objectives. The study aimed to evaluate nutritional habits and knowledge levels, as well as their relationship with selected demo-graphic and lifestyle factors, among medical and non-medical university students in Poland. Material and methods. A cross-sectional observational study was conducted from November 2024 to February 2025 with 128 Polish university students (64 medical and 64 non-medical). Data were collected via a 55-question self-administered online survey covering dietary habits, processed food consumption, stimulant drink intake, supplementation, and a 25-question nutritional knowledge test. Statistical analysis used chi-square and Student's t-Tests with significance set at alpha < 0.05. Results. Age, weight, height, and BMI were similar between groups. Daily breakfast was consumed by 50.0% of medical and 57.81% of non-medical students. Non-medical students more frequently ate processed foods (40.63% vs 25.0%) and preferred sweets as snacks (70.61% vs 65.63%). Medical students scored higher on the nutritional knowledge test (16.44 vs 14.64 points). Conclusions. Medical students demonstrated better nutritional knowledge and differed in snack choices compared to non-medical students. Other dietary habits were similar. These findings highlight the need to enhance nutrition education, particularly for nonmedical students.
