Self-medication is a subject of global importance. If practiced responsibly, self-medication represents a part of self-care or positive care of an individual or a community in promoting their own health. However, today’s practices of self-medication are often inappropriate and irresponsible, and as such appear all over the world. Inappropriate self-medication can be connected with possible serious health risks and consequences. Therefore, it represents a global health issue. It can even generate additional health problems, which will eventually become a burden to healthcare systems and can induce significant costs, which also raises socioeconomic concerns. Hence, self-medication attracts the attention of researchers and practitioners globally in efforts to clarify the current status and define feasible measures that should be implemented to address this issue. This narrative review aims to give an overview of the situation in the field of self-medication globally, including current practices and attitudes, as well as implications for actions needed to improve this problem. A PubMed/MEDLINE search was conducted for articles published in the period from 1995 up to March 2025 using keywords “self-medication” or “selfmedication” alone or in combinations with terms related to specific subthemes related to self-medication, such as COVID-19, antimicrobials, healthcare professionals, and storing habits of medicines at home. Studies were included if self-medication was their main focus. Publications that only mentioned self-medication in different contexts, but not as their main focus, were excluded. Considering the outcomes of research on self-medication in various contexts, increasing awareness of responsible self-medication through education and informing, together with surveillance of particular medicines and populations, could lead to more appropriate and beneficial self-medication in the future.

Numerous factors are involved in the pathogenesis of nonalcoholic fatty liver disease (NAFLD), which are responsible for its development and progression as an independent entity, but also thanks to their simultaneous action. This is explained by the hypothesis of multiple parallel hits. These factors are insulin resistance, lipid metabolism alteration, oxidative stress, endoplasmic reticulum stress, inflammatory cytokine liberation, gut microbiota dysbiosis or gut–liver axis activation. This is a systematic review which has an aim to show the connection between intestinal microbiota and the role of its disbalance in the development of NAFLD. The gut microbiota is made from a wide spectrum of microorganisms that has a systemic impact on human health, with a well-documented role in digestion, energy metabolism, the stimulation of the immune system, synthesis of essential nutrients, etc. It has been shown that dysbiosis is associated with all three stages of chronic liver disease. Thus, the modulation of the gut microbiota has attracted research interest as a novel therapeutic approach for the management of NAFLD patients. The modification of microbiota can be achieved by substantial diet modification and the application of probiotics or prebiotics, while the most radical effects are observed by fecal microbiota transplantation (FMT). Given the results of FMT in the context of metabolic syndrome (MetS) and NAFLD in animal models and scarce pilot studies on humans, FMT seems to be a promising treatment option that could reverse intestinal dysbiosis and thereby influence the course of NAFLD.

Background and Objectives: Tear film instability and corneal surface irregularity are important sources of variability in keratometric and corneal topographic measurements, particularly affecting astigmatic magnitude and axis. Accurate preoperative biometry is crucial for optimal refractive outcomes in cataract surgery. Dry eye disease (DED) may compromise the reproducibility of keratometric parameters, leading to errors in intraocular lens (IOL) power calculation. This study aimed to evaluate the impact of DED on the reproducibility of keratometric measurements and to assess the effect of a four-week treatment with lipid-containing artificial tears on these parameters in cataract patients. Materials and Methods: This cross-sectional study included 116 patients scheduled for cataract surgery, of whom 65 (56.0%) had DED and 51 (44.0%) served as controls. All patients underwent two preoperative keratometric measurements 10–20 min apart (IOL1 and IOL2). The control group proceeded to surgery the next day, while surgery in the DED group was postponed. Patients with DED received preoperative therapy with lipid-containing artificial tears. Follow-up assessments occurred one month after therapy (keratometric measurement named IOL3) and eight weeks postoperatively. Clinical evaluation included slit-lamp examination, dry eye testing according to Dry eye Workshop II (DEWS II) criteria: Ocular surface Disease Index (OSDI), Tear Break-Up Time (TBUT), Schirmer I, Oxford staining, and meibomian gland assessment), ocular biometry, and postoperative spherical equivalent measurement using an auto ref-keratometer. Nonparametric statistical analyses were applied to evaluate associations between parameters. Results: In the DED group, corneal astigmatism showed a significant difference between IOL1 and IOL2 (Wilcoxon signed-rank test {Z = 2.43; p = 0.015}). Significant changes in predicted IOL power were observed between pretreatment and posttreatment values (t = 2.57; p = 0.013) and between IOL2 and IOL3 (t = 2.23; p = 0.029), indicating improved keratometric stability following tear film therapy. No additional significant correlations were identified. Conclusions: DED adversely affects the reproducibility of keratometric measurements and may compromise IOL power selection. Preoperative identification and treatment of DED, followed by repeated biometry after tear film stabilization, are strongly recommended to enhance refractive accuracy and optimize surgical outcomes in cataract patients.

Background and Aim: Drug utilization worldwide is often associated with practicing self-medication of prescription or non-prescription drugs. Irresponsible behaviors in this field can lead to a variety of health risks. Assessing the extent of self-medication in population contributes to guiding decisions on future interventions to improve it. This study aimed to investigate self-medication patterns and attitudes of adult urban inhabitants in Croatian cities Zagreb and Rijeka. Methods: A cross-sectional study was conducted from April to May 2025 in urban community pharmacies involving 402 adult customers who filled out the questionnaire on their self-medication behaviors and attitudes, adverse events related to self-medication, and practices of storing medications at home. The data was analyzed using descriptive statistics. The Chi-square test was used to estimate association between sociodemographic features and self-medication practices. Results: Most commonly self-medicated drugs were analgesics-antipyretics by 94.2% participants. Antimicrobials were self-medicated in 29.4% of cases, and anxiolytics in 24.0%. Higher educational levels were associated with stronger inclination to self-medicate in general (p = 0.034). Most commonly, respondents acquired over-the counter drugs for self-medication in pharmacies (75.3%). Women bought over-the-counter drugs and reported adverse drug reactions more frequently (p = 0.033 and p = 0.037, respectively). 77.5% of participants kept drugs in a designated area (home pharmacy), and 24% of participants could not estimate if drugs they kept at home were potentially toxic. Conclusion: The prevalence of reported self-medication was rather high, even with prescription drugs such as antibiotics and anxiolytics. Educational activities and practical interventions should be implemented to increase the awareness of potential risks of inappropriate self-medication and to strengthen responsible behavior in this aspect with family physicians and community pharmacists having the key role in the process.

Background: Although glaucoma is a leading cause of irreversible blindness, no universally accepted screening guidelines for this condition have been developed. A nationwide glaucoma screening project was developed with the aim of raising awareness and assessing regional differences in intraocular pressure (IOP) and dry eye symptoms, as well as identifying potential risk factors among various Croatian regions. Methods: Over six months in 2023, 68 ophthalmologists conducted screening at 68 pharmacies across Croatia. IOP was measured using calibrated iCare IC200 tonometers, and dry eye symptoms were assessed using the Schein questionnaire. Results: A total of 7348 adults participated (median age: 63 years). IOP values and rates of newly detected elevated IOP varied by region. The highest maximum IOP was recorded in Continental Croatia (43.3 mmHg), followed by Zagreb. Newly discovered elevated IOP was most common in Slavonia (9.47%) and Continental Croatia (7.58%). Higher IOP was more frequently detected in younger participants and those with a family history of glaucoma. In coastal regions (Dalmatia, Istria, and Kvarner), elevated IOP showed a significant association with dry eye symptoms. Conclusions: This was the largest community-based glaucoma screening initiative in Croatia. The findings reveal notable regional differences in IOP and associated risk factors, underscoring the value of targeted community screening in raising awareness and identifying individuals at risk.

Background/Objectives: Nasal irrigation with isotonic seawater is a known and oft-used treatment for nasal obstruction in patients with acute and chronic nasal inflammatory disease undergoing therapy with intranasal corticosteroids and antihistamine drugs. Nasal patency in healthy athletes is extremely important; however, to date, the effect of isotonic solutions for nasal irrigation in healthy athletes has not been tested. This randomized controlled trial aimed to investigate the potential synergy of physical exercise and nasal isotonic seawater on airflow and the subjective assessment of nasal patency in healthy, high-level athletes. Methods: The intervention group included 33 healthy athletes who used an isotonic seawater nasal spray daily, with a control group including 31 healthy athletes who did not use any sprays; both groups underwent identical seven-day training periods. The primary outcome measures were subjective NOSE questionnaire scores and secondary peak nasal inspiratory flow (PNIF) measures, while anthropometric and demographic variables were covariates. Results: A significant decrease in subjective nasal resistance scores was observed in the intervention group compared to the control group (binary logistic regression model, p = 0.006, RR 7.695), both in the first and second measurement interval. This effect increased with time (Friedman’s two-way analysis of variance, p < 0.001). Peak nasal inspiratory flow is positively affected by exercise but not by isotonic seawater spray intervention. Conclusions: The effects of nasal isotonic seawater irrigation during intense athletic training are beneficial on subjective nasal patency in the short term, while the effects on objective nasal patency are less clear.